Coronary Artery DiseaseReliability of Predicting Early Hospital Readmission After Discharge for an Acute Coronary Syndrome Using Claims-Based Data
Section snippets
Methods
Details of the design, participant recruitment, interview processes, and medical record abstraction procedures used in Transitions, Risks and Action in Coronary Events (TRACE-CORE) have been previously described.7, 8 In brief, TRACE-CORE used a 6-site prospective cohort design to follow 2,187 adults discharged alive after an ACS hospitalization. Participants with an ACS were identified using active surveillance methods by trained study staff from April 2011 to May 2013. Adult patients admitted
Results
Participants were on average 73 years old, 38% were women, and 1 in 4 were college educated (Table 1). There was a high burden of co-morbid illnesses. The mean GRACE risk score was 117, suggesting intermediate risk for inhospital death.23 The average length of hospital stay was 4.6 days (median 3 days). Slightly more than half of participants experienced a Non-STEMI and 65% received a percutaneous coronary intervention during their index ACS admission.
There were 106 documented readmissions at
Discussion
In this multicenter study of >800 Medicare-age patients discharged from the hospital after an ACS from 2011 to 2013, all-cause readmissions occurred in approximately 1 of every 8 patients within 30 days of hospital discharge. We observed that chronic coronary or kidney disease, lower minimum serum sodium values, current nonsmoking status, and low health literacy during the index hospitalization were each associated with early readmission. In contrast to studies examining mortality as an
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (29)
Impact of health literacy in patients with cardiovascular diseases: A systematic review and meta-analysis
2022, Patient Education and CounselingCitation Excerpt :Four studies targeted patients with CVD other than heart failure [30,35,39,43]. Three studies focusing on readmission rate [35,39,43] and one study focusing on QOL [30] showed significant effects of health literacy. The characteristics of the included studies are summarized for heart failure and other CVD as follows: for sample size, heart failure: 95–2647 vs. other CVD: 203–6620; for mean age, heart failure: 59.2–85.6 vs. other CVD: 60.0–72.0 years; for the ratio of males, heart failure: 0.38–0.77 vs. other CVD: 0.41–0.62; and for the rate of low health literacy, heart failure: 0.10–0.53 vs. other CVD: 0.14–0.37.
Gender Difference in Secondary Prevention of Cardiovascular Disease and Outcomes Following the Survival of Acute Coronary Syndrome
2021, Heart Lung and CirculationCitation Excerpt :A recent systematic review of the Australian literature from 2000 to 2016 reported that the readmission rate for acute myocardial infarction was 13–17% [4]. In Canada, a large, multicentre (six centres) registry found that 33% of ACS patients who survived to discharge were readmitted for a cardiac reason [5]. A large number of these repeat events can be prevented by following the recommended guidelines for secondary prevention.
Evaluation of Machine Learning Algorithms for Predicting Readmission After Acute Myocardial Infarction Using Routinely Collected Clinical Data
2020, Canadian Journal of CardiologyMeasurement of health literacy in patients with cardiovascular diseases: A systematic review
2019, Research in Social and Administrative PharmacyImpact of anxiety on the post-discharge outcomes of patients discharged from the hospital after an acute coronary syndrome
2019, International Journal of CardiologyCitation Excerpt :Using data from a large and sociodemographically diverse population of patients discharged from the hospital after an ACS, we examined the association between 30-day hospital readmissions and long-term mortality among patients discharged from the hospital after an ACS who had symptoms of anxiety or a prior diagnosis of an anxiety disorder. We used data from the Transitions, Risks, and Action in Coronary Events – Center for Outcomes Research and Education (TRACE-CORE) study for this investigation [13–15]. In brief, TRACE-CORE is a multicenter prospective cohort study which included adult men and women hospitalized with an ACS at three tertiary care and community medical centers in Worcester, MA, two hospitals in Atlanta, GA, and one hospital in Macon, GA, between April 2011 and May 2013.
Predictive models for hospital readmission risk: A systematic review of methods
2018, Computer Methods and Programs in Biomedicine
Drs Ash and Kiefe contributed equally to this work.
This work was supported by 1U01HL105268-01, 1UH2TR000921-02 (to Dr. McManus), 1R15HL121761-01A1 (to Dr. McManus), and KL2TR000160 (to Dr. McManus), KL2TR000160 (to Dr. Waring) from the National Heart, Lung, and Blood Institute (Bethesda, MD) and K01AG33643 (Dr. Saczynski) from the National Institute on Aging (Bethesda, MD), both of the National Institutes of Health.
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