HCPLive Network

US Heart Attack Patients Have Elevated Hospital Readmission Rates

US Heart Attack Patients Have Elevated Hospital Readmission RatesPatients in the US who have had a type of heart attack known as an ST-segment elevation myocardial infarction (STEMI) are more likely to be readmitted to the hospital within 30 days of discharge than patients in a number of other countries, researchers have found.
 
Roughly a third of heart attacks are STEMIs, in which blood supply to the heart is cut off for a prolonged period of time, resulting in significant damage to the heart muscle and marked changes in a post–heart attack electrocardiogram. Reducing hospital readmission rates for STEMI patients has been proposed as a way of reducing health care costs.
 
For the current study, researchers used data from the Assessment of Pexelizumab in Acute Myocardial Infarction study, which enrolled 5,745 patients with STEMI in the US, Canada, Australia, New Zealand, and 13 European countries from 2004 to 2006.
 
Of the 5,571 patients who survived to hospital discharge, 631 (11.3%) were readmitted within 30 days of discharge. Patients with multivessel coronary artery disease were twice as likely to be readmitted within 30 days; patients in the US were 68% more likely to be readmitted; and patients with elevated baseline heart rate were 9% more likely to be readmitted for every 10 beats per minute increase. Even when elective readmission for revascularization was excluded, US patients were still 53% more likely to be readmitted within 30 days.
 
The 30-day readmission rate was 14.5% for US patients compared with 9.9% for patients in the other 16 countries, but the median length of stay in the hospital was shortest, at three days, for US patients. (Germany had the longest median length of stay, at eight days.) The researchers point out that the higher likelihood of readmission in the US may be due to this shorter median length of stay.
 
Nonetheless, the researchers argue that their findings back up the notion that it might be possible to reduce US health care costs by reducing hospital readmission rates for STEMI patients. “Our analysis shows that readmission may be preventable because rates are nearly one-third lower in other countries, suggesting that the US health care system has features that can be modified to decrease readmission rates,” they write, according to a press release. “Understanding these international differences may provide important insight into reducing such rates, particularly in the United States."
 
The study appears in the January 4 edition of JAMA.

Further Reading
Research indicates that there are probable etiologies of low back pain that can affect treatment outcome and that ignoring pain can possibly cause chronic neurological changes.
Researchers are learning more about the ways in which gut microbiota interact with the central nervous system and the role this can play in pain management.
Although the underlying mechanisms are not fully understood, opioid-induced hyperalgesia occurs in some patients on higher doses of opioids. Treatment options include reducing, rotating, or completely tapering the opioid regimen.
Magnetic resonance is an effective alternative to biopsy for identifying and quantifying fats in the liver, according to results from a study led by a research team at the University of the Basque Country.
Daily supplements of selenium or vitamin E don't seem to protect against the development of age-related cataracts among men, according to a study published online Sept. 18 in JAMA Ophthalmology.
Cancer patients burdened by stress and family conflicts before surgery may face a higher risk for complications following their operation, according to a study published in a recent issue of the Journal of Gastrointestinal Surgery.
President Barack Obama escalated the fight against antibiotic-resistant bacteria on Thursday, ordering key federal agencies to pursue a national strategy to deal with the threat.
More Reading