Thirty-day Hospital Readmissions in Patients with Non-ST-segment Elevation Acute Myocardial Infarction.

BACKGROUND: Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are rehospitalized shortly after admission for a non-ST-segment elevation acute myocardial infarction (NSTEMI). This observational study describes decade-long trends (1999-2009) in the magnitude and characteristics of patients readmitted to the hospital within 30 days of hospitalization for an incident (initial) episode of NSTEMI.

METHODS: We reviewed the medical records of 2249 residents of the Worcester (Mass) metropolitan area who were hospitalized for an initial NSTEMI in 6 biennial periods between 1999 and 2009 at 3 central Massachusetts medical centers.

RESULTS: The average age of our study population was 72 years, 90% were white, and 46% were women. The proportion of patients who were readmitted to the hospital for any cause within 30 days after discharge for an NSTEMI remained unchanged between 1999 and 2009 (approximately 15%) in both crude and multivariable adjusted analyses. Slight declines were observed for cardiovascular disease-related 30-day readmissions over the 10-year study period. Women, elderly patients, those with multiple chronic comorbidities or a prolonged index hospitalization, and patients who developed heart failure during their index hospitalization were at higher risk for being readmitted within 30 days than respective comparison groups.

CONCLUSION: Thirty-day hospital readmission rates after hospital discharge for a first NSTEMI remained stable between 1999 and 2009. We identified several groups at higher risk for hospital readmission; further surveillance efforts and/or tailored educational and treatment approaches remain needed for these groups.