Background: Despite improvements in acute care and survival after non-ST-elevation acute coronary syndrome (NSTE-ACS) hospitalization, early readmissions remain common, and have significant clinical and financial impact. Objectives: Determine the predictors and etiologies of 30-day readmissions in NSTE-ACS. Method: The study cohort was derived from the National Readmission Database 2014 identifying patients with a primary diagnosis of NSTE-ACS using ICD9 code. Results: We identified a total of 300,269 patients admitted with NSTE-ACS; 13.4% were readmitted within 30-day. The most common cause of readmission was heart failure (HF) (15.6%), followed by a recurrent myocardial infarction (MI) (10%). Predictors of increased readmissions were age ≥ 75 years (OR: 1.34, 95% CI: 1.30–1.39), female gender (OR 1.12, 95% CI 1.09–1.16), a Charlson Comorbidity Index (CCI) >3 (OR 2.11, 95% CI: 2.04–2.18), ESRD (OR 2.01, 95% CI 1.89–2.14), CKD (OR: 1.58, 95% CI: 1.51–1.64), length of stay ≥5 days (OR: 1.51, 95% CI 1.46–1.56) and adverse events during the index admission such as AKI (OR:1.31, 95% CI: 1.25–1.36), major bleeding (OR:1.20, 95% CI: 1.12–1.24); whereas admission to a teaching hospital (OR 0.92, 95% CI 0.89–0.95) and PCI (OR 0.70, 95% CI 0.67–0.72) were associated with less likelihood of 30-day readmission. Conclusion: Readmission rate at 30-days is high among NSTE-ACS patients and the most common readmission etiologies are HF and recurrent MI. A CCI more than 3 and ESRD were the most significant predictors for readmission; patients undergoing PCI had less odds of readmission.
- Myocardial infarction
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine