30-day Unplanned Readmission Rates and Causes in Patients Hospitalized for Acute Coronary Syndrome Based on DANish CoMorbidity Index for Acute Myocardial Infarction Score.

Abstract

Introduction: This study aimed to investigate the association of the DANish CoMorbidity Index for Acute Myocardial Infarction (DANCAMI) score with 30-day unplanned readmission rates and causes in patients with acute coronary syndrome (ACS).

Methods: Using the US National Readmission Database, all index hospitalisations with a principal diagnosis of ACS between October 2015 to December 2019 were stratified by their DANCAMI score using International Classification of Diseases - 10^thedition codes. Thirty day unplanned readmission rates and causes were analysed, including the assessment of factors associated with readmission. Multivariable regression analyses were reported as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).

Results: Of 2,066,328 ACS admissions, 173,304 (8.4%) had a DANCAMI score of 0, 602,640 (29.2%) had a DANCAMI score of 1-3, 327,046 (15.8%) had a DANCAMI score of 4-5 and 963,338 (46.6%) had a DANCAMI score ≥6. 189,240 (9.2%) had an unplanned readmission within 30 days. Patients with a higher DANCAMI score were more likely to be older and have an index presentation of non-ST-elevation ACS. A DANCAMI score ≥6 (aOR 1.30 95% CI 1.27-1.34), age (aOR 1.01 95% CI 1.01-1.01), female sex (aOR 1.09 95% CI 1.08-1.10), index ST-elevation ACS (aOR 1.03 95% CI 1.01-1.04) and atrial fibrillation (aOR 1.35 95% CI 1.33-1.37) were independently associated with readmission (all p<0.001). Higher scores were associated with an increasing likelihood readmission for non-cardiovascular causes.

Conclusion: Increased DANCAMI score was associated with higher readmissions in patients with ACS. The DANCAMI score could be a valuable tool to assess risk.