Thirty-Day Hospital Readmission After Acute Myocardial Infarction in China

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Acute myocardial infarction (AMI) readmission rates in low- and middle-income countries, specifically China, remain under-characterized.
• Understanding readmission patterns is crucial for improving post-discharge care and patient outcomes in diverse healthcare settings.

Purpose of the Study:

• To characterize the rates, timing, and diagnoses of unplanned 30-day readmissions following AMI in China.
• To identify clinical factors associated with increased or decreased risk of unplanned readmission after AMI.

Main Methods:

• A prospective cohort study involving 3387 patients hospitalized for AMI across 53 diverse Chinese hospitals.
• Analysis included descriptive statistics for readmission rates and diagnoses, and Cox proportional hazards models to identify associated factors.
• Data collected included patient demographics, clinical characteristics, length of stay, and in-hospital events.

Main Results:

• The 30-day unplanned readmission rate was 6.3%, with 77.7% of these for cardiovascular diagnoses, and nearly half occurring within 5 days of discharge.
• Higher readmission risk was linked to higher Mini-Global Registry of Acute Coronary Events scores, longer hospital stays, in-hospital recurrent angina, lower left ventricular ejection fraction, and in-hospital complications.
• Revascularization during the index hospitalization and ST-segment-elevation myocardial infarction were associated with lower readmission risks.

Conclusions:

• Unplanned readmissions after AMI in China are frequent, primarily cardiovascular, and concentrated in the early post-discharge period.
• Clinical indicators such as admission scores, length of stay, in-hospital events, and specific AMI types are key predictors of readmission.
• Social factors like income, depression, or social support did not significantly influence readmission rates in this cohort.