Sex-specific risk of emergency department revisits and early readmission following myocardial infarction

Abstract

Background: Readmissions within 30days after hospitalization have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI).

Objectives: To investigate the association between sex and revisits to the emergency department (ED), and readmissions after MI.

Methods: All patients with chest pain, diagnosed with MI at the Karolinska University Hospital during 2011 and 2012 were included. National Health care registers were used for information about patient characteristics, outcomes, and medication. We calculated risk ratios (RR) with 95% confidence intervals (CI) in women versus men, for revisits to the ED, readmission to hospital within 30, and 180days, and to undergo coronary angiography, or revascularization, and to receive guideline-directed cardiovascular medication.

Results: In total there were 667 patients with MI during the study period, of whom 197 (30%) were women. Women were older (mean age 73 vs. 65years), and had more comorbidities than men. The 30-day risk of revisits to the ED was 1.56 times greater in women than men (adjusted RR 1.56 (1.09-2.25)). Throughout the first year; women were more likely to be readmitted than men, with the most striking difference found within 30days (22% vs. 13%) of discharge (adjusted RR 1.54 (95% CI, 1.00-2.36)). There were no differences between men and women in new cardiovascular medication, coronary angiographies or revascularizations.

Conclusions: Women have an increased risk of revisits to the ED, and readmissions to hospital during the first year after a MI.

Keywords: Myocardial infarction; Readmissions; Sex-differences.