Myocardial infarction: Big minus for U.S. heart attack patients

Heart attack patients in the U.S. are more likely to be readmitted to the hospital within 30 days than patients in other countries, according to an analysis in JAMA released Tuesday.

It may be because American patients spend fewer days in the hospital post-heart attack than patients in other countries, the study’s authors wrote.

Duke University cardiologist Dr. Robb D. Kociol led a team that studied data from a clinical trial that assessed the effectiveness of the drug pexelizumab in preventing death in the 30 days following a heart attack. The trial, which was conducted between 2004 and 2006, enrolled more than 5,700 patients at nearly 300 sites in 17 countries, including the U.S., Canada, Australia, New Zealand, and 13 nations in Europe.

In all, 11.3% of patients who were discharged after suffering their heart attacks were readmitted to the hospital within 30 days. The readmission rate for U.S. patients was 14.5%. For patients in other countries, it was 9.9%. Subjects in the United States had 68% increased odds of readmission versus people in other countries, the authors wrote.

They also reported that the U.S. had the shortest median length of stay in the hospital after heart attack -- three days. The longest stay among the countries was eight days, in Germany.

While a number of factors might influence the higher rates of readmission in the U.S., the authors wrote, the link between shorter hospital stays and readmissions was an “intriguing finding.”

They noted that in the past 25 years, the length of hospital stays for heart attack patients has declined dramatically -- perhaps too much, according to some researchers.

Readmission “rates are nearly one-third lower in other countries, suggesting that the U.S. health care system has features that can be modified to decrease readmission rates,” the researchers concluded.

Read the study in JAMA.

Return to the Booster Shots blog.