Readmission of Patients with Acute Coronary Syndrome and Determinants
Larissa Marina Santana Mendonça de Oliveira1, Ingrid Maria Novais Barros de Carvalho Costa1,2, Danielle Góes da Silva3
1Universidade Federal de Sergipe - Departamento de Pós-Graduação em Ciências da Saúde, São Cristovão, SE - Brazil.
Insights
Acute coronary syndrome (ACS) readmissions were high at 21.5%, often due to cardiovascular issues. Congestive heart failure and private healthcare use predicted these readmissions.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute coronary syndrome (ACS) leads to significant hospital admissions and readmissions.
- These events increase healthcare costs and mortality rates.
Purpose of the Study:
- To investigate readmission rates in patients with ACS.
- To identify determinants associated with ACS readmissions.
Main Methods:
- Retrospective cohort study of adult and elderly ACS patients.
- Data collected on readmissions, time between admissions, and medications.
- Multiple logistic regression used to identify predictors of readmission.
Main Results:
- The readmission rate was 21.5%, with a mean time between admissions of 122.7 days.
- Cardiovascular diseases, including ACS, were the primary reasons for readmission.
- Private healthcare utilization and a history of congestive heart failure were associated with readmissions.
Conclusions:
- ACS is a major cause of hospital readmission.
- Readmission risk is higher for patients with congestive heart failure and those utilizing supplemental healthcare.
Background:
Acute coronary syndrome (ACS) is responsible for high rates of hospital admission and readmission, which are associated with increased costs for the patient and the health system, and increased in-hospital mortality rates.
Objective:
To evaluate readmission in patients with ACS and its determinants.
Methods:
This was a retrospective cohort study of adult and elderly patients with ACS, readmitted to public and private referral cardiology hospitals within one year after the first hospitalization for ACS. The occurrence of readmissions, the time elapsed from the first to the second admission, and the use of medications at admission were collected from the medical records. Associations between categorical variables were evaluated by the chi-square test or the Fisher's exact test. Multiple logistic regression was used to evaluate predictors for readmissions. A p < 0.05 was set as statistically significant.
Results:
Readmission rate was 21.5% (n = 115) and mean time between admissions was 122.7 ± 112.1 days. The patients were mostly men (64.0%), mean age of 63.15 ± 12.3 years. Among readmitted patients, 7% had a prognosis of "death", and 68.7% were readmitted more than once within a one-year period. The main reasons of readmission were cardiovascular diseases including ACS. Private health care and the diagnosis of congestive heart failure were associated with multiple logistic regression.
Conclusion:
ACS was the main cause of readmission, with higher prevalence among users of supplemental health care. Readmissions were associated with previous diagnosis of congestive heart failure and the type of health care provided.
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