Author + information
- Rohan Kheraa,b,
- Saket Girotraa,b,
- Ambarish Pandeya,b,
- Snigdha Jaina,b,
- Colby Ayersa,b,
- Sandeep Dasa,b,
- Jarett Berrya,b,
- James A. de Lemosa,b and
- Gregg Fonarowa,b
Background: In patients (pts) ≥ 65y admitted with acute myocardial infarction (AMI) and heart failure (HF), 30d readmissions account for substantial Medicare resource use. Few data are available for early post-discharge healthcare utilization after AMI/HF in pts < 65y.
Methods: In the US Nationwide Readmission Database, we identified 478247 AMI and 876525 HF admissions between Jan-Nov 2013. National admission, 30d readmission and cost data were estimated and stratified by age. Demographic predictors for readmissions were examined using hierarchical models.
Results: Pts <65y accounted for 44% of AMI and 28% of HF admissions. Of the $10.2 and $9.4 billion cost of primary AMI and HF admissions, 46% in AMI and 35% in HF were spent on those <65y. Overall, 14% and 23% of pts were readmitted after AMI and HF, and those <65y represented 33% of AMI and 30% of HF readmissions. National cost of 30d readmission was $1 billion for AMI and $3 billion for HF – 34% (AMI) and 35% (HF) were spent on those <65y. In risk-adjusted analyses for AMI, compared to pts >65y, those <65y had fewer readmissions but women and low income pts in this group had higher risk. In contrast, in HF, pts <65y had higher readmission risk, but the effect of sex and income varied between subgroups of pts <65y.
Conclusions: Among US pts admitted with AMI or HF those <65y use substantial healthcare resources. Demographic predictors of readmission risk differ between pts <65y and >65y. Further investigation into post-hospitalization outcomes in the young is warranted.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-322
- 2017 American College of Cardiology Foundation