Volume 113, Nº 1, July 2019
DOI: http://www.dx.doi.org/10.5935/abc.20190104
ORIGINAL ARTICLE
Readmission of Patients with Acute Coronary Syndrome and Determinants
Larissa Marina Santana Mendonça de Oliveira
Ingrid Maria Novais Barros de Carvalho Costa
Danielle Góes da Silva
José Rodrigo Santos Santos Silva
José Augusto Soares Barreto-Filho
Marcos Antônio Almeida‑Santos
Joselina Luzia Meneses Oliveira
Mirella Dornelas Batalha Moreira Buarque
Diva Aliete dos Santos Vieira
Antônio Carlos Sobral Sousa
Abstract
Background: Acute coronary syndrome (ACS) is responsible for high rates of hospital admission and readmission, which are associated with increased costs for the patient and the health system, and increased in-hospital mortality rates.
Objective: To evaluate readmission in patients with ACS and its determinants.
Methods: This was a retrospective cohort study of adult and elderly patients with ACS, readmitted to public and private referral cardiology hospitals within one year after the first hospitalization for ACS. The occurrence of readmissions, the time elapsed from the first to the second admission, and the use of medications at admission were collected from the medical records. Associations between categorical variables were evaluated by the chi-square test or the Fisher’s exact test. Multiple logistic regression was used to evaluate predictors for readmissions. A p < 0.05 was set as statistically significant.
Results: Readmission rate was 21.5% (n = 115) and mean time between admissions was 122.7 ± 112.1 days. The patients were mostly men (64.0%), mean age of 63.15 ± 12.3 years. Among readmitted patients, 7% had a prognosis of “death”, and 68.7% were readmitted more than once within a one-year period. The main reasons of readmission were cardiovascular diseases including ACS. Private health care and the diagnosis of congestive heart failure were associated with multiple logistic regression.
Conclusion: ACS was the main cause of readmission, with higher prevalence among users of supplemental health care. Readmissions were associated with previous diagnosis of congestive heart failure and the type of health care provided. (Arq Bras Cardiol. 2019; 113(1):42-49)
Keywords: Acute Coronary Syndrome; Hospitalization/economy; Patient Readmission/economy; Heart Failure; Delivery of Health Care/economy; Hospital Mortality; Socioeconomic Factors; Drug Therapy/economia.
