Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2012;65:414-20 - Vol. 65 Num.05 DOI: 10.1016/j.rec.2011.09.012

Long-Term Mortality and Hospital Readmission After Acute Myocardial Infarction, an Eight-Year Follow-Up Study

Eva Andrés a,, Alberto Cordero b, Purificación Magán a, Eduardo Alegría c, Montserrat León d, Emilio Luengo d, Rosa Magallón Botaya e, Luis García Ortiz f, José A. Casasnovas d

a Instituto de Investigación 12 de Octubre (i+12), Ciber de Epidemiología y Salud Pública, Madrid, Spain
b Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
c Policlínica Guipúzcoa, San Sebastián, Guipúzcoa, Spain
d Unidad de Investigación Cardiovascular, Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
e Unidad de Investigación en Atención Primaria, Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
f Unidad de Investigación de La Alamedilla, Sacyl, Salamanca, Spain

Refers to

Keywords

Myocardial infarction. Readmission. Prognosis. Survival.

Abstract

Introduction and objectives

Acute myocardial infarction is responsible for most of the deaths in developed countries and for a very large number of hospital admissions. Specifically in Spain, each year about 140 000 deaths and 5 million hospital stays are due to acute myocardial infarction, corresponding to health care costs reaching 15% of total expenditure. Therefore, this paper presents an exhaustive analysis of acute myocardial infarction and the related prognosis, such as recurrence and mortality.

Methods

This observational study was carried out in Spain. Data were obtained using the Hospital Discharge Administrative Database from 2000 through 2007, inclusive. Specifically, 12 096 cases of acute myocardial infarction (8606 women and 3490 men) were reported during this period, with 2395 readmissions for this diagnosis. Readmissions were analyzed for frequency and duration using logistic regression and the Wang survival model. Mortality was analyzed using logistic regression.

Results

Readmission rates were 50% for patients younger than 45 years and 38% for those older than 75 years (P<.001). Men were readmitted more frequently than women throughout the follow-up period. Variables related to hospital mortality from acute myocardial infarction were the presence of diabetes, previous ischemic heart disease, and cerebrovascular disease.

Conclusions

Mid-term hospital readmissions are highly frequent in acute myocardial infarction survivors. Male sex, previous coronary heart disease, and the number of classical cardiovascular risk factors are the major risk predictors of this readmission. Our results highlight the need for improved medical care during acute myocardial infarction admission, integrated into secondary prevention programs.

1885-5857/© 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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