Long-term mortality and hospital readmission after acute myocardial infarction: an eight-year follow-up study.

INTRODUCTION AND OBJECTIVES Acute myocardial infarction is responsible for most of the deaths in developed countries and for a very large number of hospital admissions. Specifically in Spain, each year about 140,000 deaths and 5 million hospital stays are due to acute myocardial infarction, corresponding to health care costs reaching 15% of total expenditure. Therefore, this paper presents an exhaustive analysis of acute myocardial infarction and the related prognosis, such as recurrence and mortality. METHODS This observational study was carried out in Spain. Data were obtained using the Hospital Discharge Administrative Database from 2000 through 2007, inclusive. Specifically, 12,096 cases of acute myocardial infarction (8606 women and 3490 men) were reported during this period, with 2395 readmissions for this diagnosis. Readmissions were analyzed for frequency and duration using logistic regression and the Wang survival model. Mortality was analyzed using logistic regression. RESULTS Readmission rates were 50% for patients younger than 45 years and 38% for those older than 75 years (P<.001). Men were readmitted more frequently than women throughout the follow-up period. Variables related to hospital mortality from acute myocardial infarction were the presence of diabetes, previous ischemic heart disease, and cerebrovascular disease. CONCLUSIONS Mid-term hospital readmissions are highly frequent in acute myocardial infarction survivors. Male sex, previous coronary heart disease, and the number of classical cardiovascular risk factors are the major risk predictors of this readmission. Our results highlight the need for improved medical care during acute myocardial infarction admission, integrated into secondary prevention programs.