Author + information
- Michael Salerno,
- Nancy Fauber,
- Dorothy Wessels,
- Robert Case,
- Vertilio Cornielle Caamano,
- Mark Conaway and
- Ellen Keeley
Background: The Center for Medicare and Medicaid Services (CMS) and other payers are increasingly focusing on 30 day readmissions as a quality metric tied to hospital payments. Factors that predict 30-day readmission in patients admitted with acute myocardial infarctions (AMI) have not been extensively studied.
Methods: We retrospectively analyzed our Vizient billing database of all admissions to our institution with a primary diagnosis of AMI (ICD9 code 410.xx) from September 2010 to July 2016, and investigated the relationship between patient parameters and admission factors and unplanned readmission within 30 days. Time to readmission was modeled using a multivariate Cox Proportional Hazard (PH) Model and data was censored at 30 days.
Results: During this time frame, 2732 patients were admitted with AMI and 243 unplanned readmissions occurred (8.9% readmission rate). The average age was 65±13, 65% were male, 53% had HTN, 37% had diabetes, and 60% had hyperlipidemia. The Cox PH model parameters and Hazard Ratios are shown in Table 1. Notably, age, race, hyperlipidemia, presence of heart failure, smoking status, type of AMI, revascularization during index hospitalization, or length of stay were not significant multivariate predictors of 30 day readmission.
Conclusions: Female sex, atrial fibrillation, diabetes, ESRD, Medicare as the primary payer, discharge with home health or to rehab/SNF, and emergent/elective admission were multivariate predictors of 30-day readmission.
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: 1253-328
- 2017 American College of Cardiology Foundation