Arq. Bras. Cardiol. 2019; 113(1): 50-51
Hospital Readmissions after Acute Coronary Syndromes
DOI: 10.5935/abc.20190136
This Short Editorial is referred by the Research article "Readmission of Patients with Acute Coronary Syndrome and Determinants".
Acute ischemic syndromes (myocardial infarction, unstable angina) may occur de novo in previously asymptomatic patients or may occur in the course of chronic diseases. After hospital-based acute care therapy, with or without percutaneous or surgical intervention, patients are discharged and receive advice for long-term therapy. However, some patients develop symptoms again in the short-term course and are readmitted to the hospital due to clinical as well as non-clinical causes and with clinical and other non-clinical consequences.
Hospital readmissions deserve studies in different settings and have been reported in medical literature. In one report, the readmission rate after one year in patients older than 65 years surviving myocardial infarction was 49.9% in 4.767 hospitals in United States of America between 2008 and 2010; the readmission rate, as well as mortality, were higher in the first months after discharge and decreased thereafter over 12 months. Additional studies compared not-for-profit hospitals (15.7%) with proprietary hospitals (16.6%) regarding readmission rates in the first month of discharge without demonstrating an association of hospital ownership with the success in programs devoted to decrease readmission rate; the results of such interventions were not statistically different between the two types of hospitals. Socioeconomic and ethnic factors were systemic influences without overt manifestations in a specific hospital. In many instances, the readmission rate was studied as a surrogate marker of quality of care;– the heterogeneity of patients and medical conditions made a clear association with the index admission elusive and not easily predicted.
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