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Comparison of 1, 2, and 6-Month Readmission Rates in Patients With Acute Myocardial Infarction Directly Admitted to Hospital Versus Transferred From Another Hospital to an Academic Medical Center.
Am J Cardiol. 2017 May 10;:
Authors: Chidester JP, Keeley EC
Abstract
Patients with acute myocardial infarction (AMI) who are transferred are less likely than directly admitted patients to receive outpatient follow-up within 30 days and are more likely to be readmitted. In 2015, we launched a clinic where post-AMI patients (direct admits and transfers) are seen within 1 week of hospital discharge. We compared short- and long-term clinical outcomes of patients who were transferred to patients who were directly admitted to our institution to determine the impact of transfer status on early outpatient follow-up and clinical outcomes. A total of 280 post-AMI patients, 193 direct admissions (69%), and 87 transfers (31%) were referred to the clinic. Clinic attendance was similar between the transferred and the directly admitted patients (91% vs 92%, p = 0.688, respectively). Transferred patients had similar rates of confusion regarding their medical regimen as the directly admitted patients (11% vs 8%, p = 0.393). Compared with directly admitted patients, transferred patients lived farther from the hospital (median distance of 30 vs 48 miles, p <0.0001), were predominately white (77% vs 91%, p = 0.005), and had higher rates of chronic obstructive pulmonary disease (9% vs 17%, p = 0.014). There was no difference in 30- (16% vs 13%, p = 0.562) or 60-day readmission rates (6% vs 8%, p = 0.543) between transferred patients and directly admitted patients. At 6 months, mortality rates were similar (6% vs 4%, p = 0.556). In conclusion, transferred patients who were evaluated early after hospital discharge for acute MI had similar clinical outcomes (including rates of unplanned readmissions) to their directly admitted counterparts.
PMID: 28576268 [PubMed - as supplied by publisher]