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Readmissions Rates After Myocardial Infarction for Gastrointestinal Bleeding: A National Perspective

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Abstract

Background and Aims

Gastrointestinal (GI) bleeding is one most common complications of acute myocardial infarction (AMI). We aimed to determine the incidence, in-hospital outcomes, associated healthcare burden and predictors of GI bleeding within 30 days after AMI.

Methods

Data were extracted from Nationwide Readmission Database 2010–2014. Patients were included if they had a primary diagnosis of ST or non-ST elevation myocardial infarction. Exclusion criteria were admissioned in December, aged less than 18 years and a diagnosis of type-2 MI. The primary outcome was 30-day readmission with upper or lower GI bleeding. Secondary outcomes were in-hospital mortality, etiology of bleeding, in-hospital complications, procedures, length of stay, and total hospitalization charges. Independent predictors of readmission were identified using multivariate logistic regression analysis.

Results

Out of the 3,520,241 patients discharged with ACS, 10,018 (0.3%) were readmitted with GI bleeding within 30 days of discharge. 60% had lower GI bleeding. Most common sources suspected were GI cancers in 17% and hemorrhoidal bleeding in 10%. In hospital mortality rate for readmission was 3.6%. Independent predictors of readmission were age, Charlson comorbidity score, history of chronic kidney disease, GI tumor, inflammatory bowel disease and artificial heart valve. Type of treatment for AMI had no impact on readmission. Patients readmitted had higher rates of shock (adjusted odds ratio, 1.48, 95% CI 1.01–3.72).

Conclusions

In the first nationwide study, 30-day incidence of GI bleeding after AMI is 0.3%. GI bleeding complicating AMI carries a substantial in-hospital mortality and cost of care.

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Funding

The authors declare that there was no grant or financial support received whatsoever for the research conducted by us and writing of this article.

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Authors and Affiliations

  1. Department of Internal Medicine, UMMS-Baystate Medical Center, Springfield, MA, USA

    Kamesh Gupta, Khalid Sawalha & Mohammed Abozenah

  2. Department of Internal Medicine, West Virginia University- Charleston Division, Charleston, WV, USA

    Ahmad Khan

  3. Department of Internal Medicine, Yale-Danbury Hospital, Danbury, CT, USA

    Manish Kumar

  4. Department of Gastroenterology, UMMS-Baystate Medical Center, Springfield, MA, USA

    Rohit Singhania

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  1. Kamesh Gupta
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Correspondence to Kamesh Gupta.

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Gupta, K., Khan, A., Kumar, M. et al. Readmissions Rates After Myocardial Infarction for Gastrointestinal Bleeding: A National Perspective. Dig Dis Sci 66, 751–759 (2021). https://doi.org/10.1007/s10620-020-06315-1

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