Table 3.
Association Between Various Prognostic Factors and 30‐Day All‐Cause Rehospitalizations Among Patients Who Survived an AMI: Worcester Heart Attack Study, 2001–2011 (N=4810)
| Factors | Adjusted for Sociodemographics and Comorbiditiesa | Further Adjusted for in‐Hospital Factorsb | Further Adjusted for Hospital Treatment Practicesc |
|---|---|---|---|
| Adjusted OR (95% CI) | |||
| Age <55 y | 1.00 | 1.00 | 1.00 |
| Age 55 to 64 y | 1.16 (0.75–1.78) | 1.10 (0.73–1.67) | 1.10 (0.75–1.63) |
| Age 65 to 74 y | 1.32 (0.84–2.08) | 1.19 (0.79–1.79) | 1.19 (0.81–1.75) |
| Age 75 to 84 y | 1.51 (1.00–2.27) | 1.34 (0.91–1.95) | 1.28 (0.88–1.85) |
| Age 85+ y | 1.38 (0.79–2.41) | 1.21 (0.76–1.92) | 1.06 (0.66–1.72) |
| Female (vs male) | 1.28 (1.09–1.50) | 1.29 (1.10–1.52) | 1.26 (1.09–1.46) |
| White (vs nonwhite) | 0.74 (0.50–1.09) | 0.73 (0.47–1.12) | 0.74 (0.49–1.11) |
| Married (vs not married) | 1.06 (0.87–1.30) | 1.07 (0.88–1.31) | 1.08 (0.90–1.31) |
| Comorbidity | |||
| Angina | 1.07 (0.88–1.31) | 1.08 (0.89–1.32) | 1.10 (0.90–1.36) |
| Atrial fibrillation | 1.30 (0.96–1.74) | 1.17 (0.85–1.62) | 1.15 (0.85–1.56) |
| Heart failure | 1.42 (1.17–1.73) | 1.27 (1.02–1.58) | 1.24 (1.02–1.50) |
| Hypertension | 1.00 (0.81–1.23) | 1.00 (0.81–1.22) | 1.00 (0.82–1.22) |
| Peripheral vascular disease | 1.23 (0.89–1.71) | 1.19 (0.85–1.65) | 1.20 (0.87–1.66) |
| Stroke | 1.06 (0.76–1.46) | 1.08 (0.77–1.50) | 1.04 (0.75–1.43) |
| Diabetes | 1.16 (1.00–1.33) | 1.12 (0.97–1.29) | 1.11 (0.97–1.27) |
| Chronic obstructive pulmonary disease | 1.06 (0.84–1.35) | 1.02 (0.79–1.33) | 1.02 (0.79–1.30) |
| Depression | 1.05 (0.85–1.30) | 1.06 (0.86–1.30) | 1.06 (0.87–1.29) |
| Chronic kidney disease | 1.42 (1.09–1.86) | 1.36 (1.04–1.77) | 1.31 (1.03–1.67) |
| Initial AMI (vs prior AMI) | 0.87 (0.73–1.03) | 0.88 (0.75–1.03) | |
| ST‐segment myocardial infarction | 1.10 (0.91–1.32) | 1.13 (0.96–1.34) | |
| Hospital length of stay (/d) | 1.01 (0.99–1.03) | 1.01 (1.00–1.03) | |
| In‐hospital clinical complication | |||
| Atrial fibrillation | 1.31 (1.00–1.72) | 1.32 (0.99–1.75) | |
| Cardiogenic shock | 1.51 (1.10–2.07) | 1.59 (1.18–2.14) | |
| Stroke | 0.86 (0.22–3.38) | 0.87 (0.23–3.26) | |
| Heart failure | 1.35 (1.12–1.64) | 1.32 (1.10–1.57) | |
| Coronary diagnostic/interventional procedure | |||
| No coronary procedure | 1.00 | ||
| Cardiac catheterization | 0.77 (0.60–0.99) | ||
| Cardiac catheterization and PCI and/or CABG | 0.70 (0.54–0.90) | ||
| Thrombolytic therapy | 1.29 (0.79–2.10) | ||
| Medication at hospital discharge | |||
| ACEIs/ARBs | 1.05 (0.83–1.33) | ||
| Aspirins | 1.24 (1.00–1.54) | ||
| Blockers | 1.07 (0.85–1.34) | ||
| Lipid‐lowering agents | 0.97 (0.79–1.20) | ||
ACEI indicates angiotensin‐converting inhibitor; AMI, acute myocardial infarction; ARB, angiotensin type II receptor blocker; CABG, coronary artery bypass grafting; OR, odds ratios; PCI, percutaneous coronary intervention.
Adjusted for study period, sociodemographic characteristics, and comorbidities.
Adjusted for study period, sociodemographic characteristics, comorbid conditions, AMI order, AMI type, in‐hospital clinical complications, and hospital length of stay.
Adjusted for study period, sociodemographic characteristics, comorbid conditions, in‐hospital factors, and in‐hospital management as represented by thrombolytic therapy and receipt of 3 coronary interventional procedures (cardiac catheterization, PCI, and CABG) and prescribing of 4 guideline‐recommended cardiac medications (ACEIs/ARBs, lipid‐lowering agents, β‐blockers, and aspirin) at the time of hospital discharge.