Department of Internal Medicine Saint Peter's University Hospital New Brunswick NJ USA.
Now with Department of Cardiovascular Medicine West Virginia University Medicine Heart and Vascular Institute Morgantown WV USA.
J Am Heart Assoc. 2023 Aug;12(15):e029738. doi: 10.1161/JAHA.123.029738. Epub 2023 Jul 25.
Background Rates, causes, and predictors of readmission in patients with ST-segment-elevation myocardial infarction (STEMI) during COVID-19 pandemic are unknown. Methods and Results All hospitalizations for STEMI were selected from the US Nationwide Readmissions Database 2020 and were stratified by the presence of COVID-19. Primary outcome was 30-day readmission. Multivariable hierarchical generalized logistic regression analysis was performed to compare 30-day readmission between patients with STEMI with and without COVID-19 and to identify the predictors of 30-day readmissions in patients with STEMI and COVID-19. The rate of 30-day all-cause readmission was 11.4% in patients with STEMI who had COVID-19 and 10.6% in those without COVID-19, with the adjusted odds ratio (OR) not being significantly different between the two groups (OR, 0.88 [95% CI, 0.73-1.07], =0.200). Of all 30-day readmissions in patients with STEMI and COVID-19, 41% were for cardiac causes. Among the cardiac causes, 56% were secondary to acute coronary syndrome, while among the noncardiac causes, infections were the most prevalent. Among the causes of 30-day readmissions, infectious causes were significantly higher for patients with STEMI who had COVID-19 compared with those without COVID-19 (29.9% versus 11.3%, =0.001). In a multivariable model, congestive heart failure, chronic kidney disease, low median household income, and length of stay ≥5 days were found to be associated with an increased risk of 30-day readmission. Conclusions Post-STEMI, 30-day readmission rates were similar between patients with and without COVID-19. Cardiac causes were the most common causes for 30-day readmissions, and infections were the most prevalent noncardiac causes.
在 COVID-19 大流行期间，ST 段抬高型心肌梗死（STEMI）患者的再入院率、病因和预测因素尚不清楚。
从 2020 年美国全国再入院数据库中选择所有 STEMI 住院患者，并按 COVID-19 存在情况进行分层。主要结局为 30 天再入院。采用多变量层次广义逻辑回归分析比较 STEMI 合并和不合并 COVID-19 患者的 30 天再入院率，并确定 STEMI 合并 COVID-19 患者 30 天再入院的预测因素。STEMI 合并 COVID-19 患者的 30 天全因再入院率为 11.4%，STEMI 不合并 COVID-19 患者为 10.6%，两组间调整后比值比（OR）无显著差异（OR，0.88 [95%CI，0.73-1.07]，=0.200）。STEMI 合并 COVID-19 患者所有 30 天再入院中，41%为心脏原因。在心脏原因中，56%继发于急性冠状动脉综合征，而非心脏原因中，感染最为常见。在 30 天再入院的原因中，STEMI 合并 COVID-19 患者的感染原因明显高于不合并 COVID-19 患者（29.9%比 11.3%，=0.001）。在多变量模型中，充血性心力衰竭、慢性肾脏病、中等家庭收入、住院时间≥5 天与 30 天再入院风险增加相关。
STEMI 后，合并和不合并 COVID-19 的患者 30 天再入院率相似。心脏原因是 30 天再入院的最常见原因，感染是非心脏原因中最常见的原因。
