When physicians track seven factors of heart attack patients after they are first admitted to the hospital, they can help identify those with the highest risk for 30-day readmission, researchers from Dallas-based UT Southwestern Medical Center found.
The findings of the study, published in Journal of the American Heart Association, may help recognize patients who could benefit from early interventions that let them recover at home, reducing healthcare costs, the researchers said.
"Identifying the most vulnerable patients is the first step to getting these patients the specialized care they need as they are transitioning from hospital to home, so that they are then able to make a full recovery at home instead of having to come back to the hospital," said study author Oanh Nguyen, MD.
Most prediction models for heart attack patients have poor to modest success finding those most likely to be readmitted. Currently, about 1 in 6 heart attack patients, or acute myocardial infarction patients, have an unplanned hospital readmission within 30 days of discharge, the study authors note.
"We found that a simple score, the AMI READMITS score, helps physicians accurately predict which patients hospitalized for heart attacks are at high risk of 30-day readmissions," Dr. Nguyen said. "The AMI READMITS score is based on seven clinical and demographic factors that are readily available on all patients on the first day of their hospitalization."
Here are the seven READMITS factors, which can be tracked on a patient's first day of hospitalization:
- Renal (kidney) function
- Elevated brain natriuretic peptide (a marker for heart strain)
- Age
- Diabetes mellitus
- NonMale sex
- Intervention with timely percutaneous coronary intervention (i.e., heart stents)
- Low Systolic blood pressure
"We hope that the score will help physicians and hospitals better tailor and improve the quality of care for patients during and immediately after a hospitalization for a heart attack," Dr. Nguyen said. "Additionally, because the score is simple and easy to calculate, physicians can use it at the bedside to determine a patient's risk of hospital readmission."
Although physicians can find high-risk patients early in their stay, it doesn't necessarily mean interventions to reduce readmissions will be successful, Dr. Nguyen said. "That is the ultimate goal and something that we are actively working on."