In patients having noncardiac surgery who develop a perioperative acute myocardial infarction (AMI), about one in three died in-hospital or were readmitted within 30 days of discharge, finds this study presented March 10 at the 2018 American College of Cardiology Annual Scientific Session.
Among more than 3 million hospitalizations analyzed in the US Nationwide Readmission Database, researchers identified 8,085 patients with perioperative AMI. Of these, 1,135 (14.0%) died in-hospital. Survivors of AMI were more likely to be readmitted in 30 days than surgical patients without AMI (19.1% vs 6.5%).
Most common reasons for readmission were infectious complications (30.0%), cardiovascular complications (25.3%), and bleeding (10.4%). In-hospital mortality during readmission in the first 30 days was 11.3%. At 6 months, mortality risk was 17.6% and readmission was 36.2%.
The data suggest that mortality among perioperative AMI patients poses a significant burden to the healthcare system and there need to be strategies to improve outcomes in these patients, the authors say.
What are the frequency, causes, and outcomes of 30-day hospital readmission after perioperative acute myocardial infarction (AMI)? The investigators identified patients who were diagnosed with AMI during hospitalization for major noncardiac surgery using the 2014 United States Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified.