Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.

<h4>Aims</h4>Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000-2015.<h4>Methods and results</h4>Cohort study o...

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Autores principales:	J Afonso Rocha, José Carlos Cardoso, Alberto Freitas, Thomas G Allison, Luís F Azevedo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e638f5aca1cc45e1a57d23a2591744d7
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spelling	oai:doaj.org-article:e638f5aca1cc45e1a57d23a2591744d72021-12-02T20:06:31ZTime-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.1932-620310.1371/journal.pone.0255134https://doaj.org/article/e638f5aca1cc45e1a57d23a2591744d72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255134https://doaj.org/toc/1932-6203<h4>Aims</h4>Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000-2015.<h4>Methods and results</h4>Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm to identify and link patient-level sequential hospitalizations occurring within 30 days from first admission (considering all hospitalizations within the 30-day timeframe as belonging to the same ACS episode of care-ACS-EC). From 212,481 ACS-EC, 42,670 (20.1%) had more than one hospitalization. ACS-EC hospitalization rates decreased throughout the study period (2000: 207.7/100.000 person-years to 2015: 185,8/100,000 person-years, p for trend <0.05). Proportion of IHT increased from 10.5% in 2000 to 20.1% in 2015 compared to a reduction in both planned and unplanned 30-day ACS rehospitalization from 9.0% in 2000 to 2.7% in 2015. After adjusting for patient and first admission hospital's characteristics, compared to 2000-2003, in 2012-2015 the odds of IHT increased by 3.81 (95%CI: 3.65-3.98); the odds of unplanned and planned 30-day ACS rehospitalization decreased by 0.36 (95%CI: 0.33; 0.39) and 0.47 (95%CI: 0.43; 0.53), respectively. Female sex, older age and the presence and severity of comorbidities were associated with lower likelihood of being transferred or having a planned 30-day ACS rehospitalization. Unplanned 30-day ACS rehospitalization was more likely in patients with higher comorbidity burden.<h4>Conclusion</h4>IHT and 30-day ACS rehospitalization reflect coronary referral network efficiency and access to specialized treatment. Identifying factors associated with higher likelihood of IHT and 30-day ACS rehospitalization may allow heightened surveillance and interventions to reduce rehospitalizations and inequities in access to specialized treatment.J Afonso RochaJosé Carlos CardosoAlberto FreitasThomas G AllisonLuís F AzevedoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255134 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q J Afonso Rocha José Carlos Cardoso Alberto Freitas Thomas G Allison Luís F Azevedo Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
description	<h4>Aims</h4>Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000-2015.<h4>Methods and results</h4>Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm to identify and link patient-level sequential hospitalizations occurring within 30 days from first admission (considering all hospitalizations within the 30-day timeframe as belonging to the same ACS episode of care-ACS-EC). From 212,481 ACS-EC, 42,670 (20.1%) had more than one hospitalization. ACS-EC hospitalization rates decreased throughout the study period (2000: 207.7/100.000 person-years to 2015: 185,8/100,000 person-years, p for trend <0.05). Proportion of IHT increased from 10.5% in 2000 to 20.1% in 2015 compared to a reduction in both planned and unplanned 30-day ACS rehospitalization from 9.0% in 2000 to 2.7% in 2015. After adjusting for patient and first admission hospital's characteristics, compared to 2000-2003, in 2012-2015 the odds of IHT increased by 3.81 (95%CI: 3.65-3.98); the odds of unplanned and planned 30-day ACS rehospitalization decreased by 0.36 (95%CI: 0.33; 0.39) and 0.47 (95%CI: 0.43; 0.53), respectively. Female sex, older age and the presence and severity of comorbidities were associated with lower likelihood of being transferred or having a planned 30-day ACS rehospitalization. Unplanned 30-day ACS rehospitalization was more likely in patients with higher comorbidity burden.<h4>Conclusion</h4>IHT and 30-day ACS rehospitalization reflect coronary referral network efficiency and access to specialized treatment. Identifying factors associated with higher likelihood of IHT and 30-day ACS rehospitalization may allow heightened surveillance and interventions to reduce rehospitalizations and inequities in access to specialized treatment.
format	article
author	J Afonso Rocha José Carlos Cardoso Alberto Freitas Thomas G Allison Luís F Azevedo
author_facet	J Afonso Rocha José Carlos Cardoso Alberto Freitas Thomas G Allison Luís F Azevedo
author_sort	J Afonso Rocha
title	Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
title_short	Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
title_full	Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
title_fullStr	Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
title_full_unstemmed	Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
title_sort	time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e638f5aca1cc45e1a57d23a2591744d7
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_version_	1718375394251374592

Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.

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