Article ; Online: Impact of frailty on outcomes in acute ST-elevated myocardial infarctions undergoing percutaneous coronary intervention.
2023 Volume 101, Issue 4, Page(s) 773–786
Abstract: Aims: We analyzed the impact of frailty on readmission rates for ST-elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.: Methods and results: The 2016-2019 Nationwide ... ...
Abstract | Aims: We analyzed the impact of frailty on readmission rates for ST-elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions. Methods and results: The 2016-2019 Nationwide Readmission Database was analyzed for patients admitted with an acute STEMI. Patients were categorized by frailty risk and analyzed for 30-day readmission risk after acute STEMIs, PCI utilization and outcomes, and healthcare resource utilization. Qualifying index admissions were found in 584,918 visits. Low risk frailty was noted in 78.20%, intermediate risk in 20.67%, and high risk in 1.14% of admissions. Thirty-day readmissions occurred in 7.74% of index admissions, increasing with frailty (p < 0.001). Readmission risk increased with frailty, 1.37 times with intermediate and 1.21 times with high-risk frailty. PCI was performed in 86.40% of low-risk, 66.03% of intermediate-risk, and 58.90% of high-risk patients (p < 0.001). Intermediate patients were 55.02% less likely and high-risk patients were 61.26% less likely to undergo PCI (p < 0.001). Length of stay means for index admissions were 2.96, 7.83, and 16.32 days for low, intermediate, and high-risk groups. Intermediate and high-risk frailty had longer length of stay, higher total cost, and were more likely to be discharged to a skilled facility (p < 0.001). Conclusion: Among adult, all-payer inpatient visits, frailty discerned by the hospital frailty risk score was associated with increased readmissions, increased healthcare resource utilization, and lower PCI administration. |
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MeSH term(s) | Adult ; Humans ; ST Elevation Myocardial Infarction/etiology ; Percutaneous Coronary Intervention/adverse effects ; Treatment Outcome ; Hospitalization ; Patient Readmission ; Risk Factors ; Anterior Wall Myocardial Infarction/etiology ; Arrhythmias, Cardiac/etiology |
Language | English |
Publishing date | 2023-02-19 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 1459995-8 |
ISSN | 1522-726X ; 1522-1946 |
ISSN (online) | 1522-726X |
ISSN | 1522-1946 |
DOI | 10.1002/ccd.30595 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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