Sokhal Balamrit Singh, Matetić Andrija, Marshall Michelle, Twohig Helen, Shepherd Thomas, Mallen Christian D, Mamas Mamas A
School of Medicine, Keele University, Keele, Staffordshire, United Kingdom; Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, United Kingdom; Royal Stoke University Hospital, University Hospitals North Midlands, Stoke-On-Trent, Staffordshire, United Kingdom.
Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, United Kingdom; Department of Cardiology, University Hospital of Split, Split, Croatia.
Hellenic J Cardiol. 2025 Feb 3. doi: 10.1016/j.hjc.2025.01.006.
This study aimed to investigate the association of the DANish CoMorbidity Index for Acute Myocardial Infarction (DANCAMI) score with 30-day unplanned readmission rates and causes in patients with acute coronary syndrome (ACS).
Using the US National Readmission Database, all index hospitalisations with a principal diagnosis of ACS between October 2015 and December 2019 were stratified by their DANCAMI score using International Classification of Diseases-10th edition codes. Thirty-day unplanned readmission rates and causes were analysed, including the assessment of factors associated with readmission. Multivariable regression analyses were reported as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).
Of 2,066,328 ACS admissions, 173,304 (8.4%) had a DANCAMI score of 0, 602,640 (29.2%) had a DANCAMI score of 1-3, 327,046 (15.8%) had a DANCAMI score of 4-5, and 963,338 (46.6%) had a DANCAMI score ≥6. 189,240 (9.2%) had an unplanned readmission within 30 days. Patients with a higher DANCAMI score were more likely to be older and have an index presentation of non-ST-elevation ACS. A DANCAMI score ≥6 (aOR 1.30 95% CI 1.27-1.34), age (aOR 1.01 95% CI 1.01-1.01), female sex (aOR 1.09 95% CI 1.08-1.10), index ST-elevation ACS (aOR 1.03 95% CI 1.01-1.04), and atrial fibrillation (aOR 1.35 95% CI 1.33-1.37) were independently associated with readmission (all p < 0.001). Higher scores were associated with an increasing likelihood of readmission for non-cardiovascular causes.
Increased DANCAMI score was associated with higher readmissions in patients with ACS. The DANCAMI score could be a valuable tool to assess risk.
本研究旨在调查丹麦急性心肌梗死合并症指数（DANCAMI）评分与急性冠状动脉综合征（ACS）患者30天内非计划再入院率及其原因之间的关联。
利用美国国家再入院数据库，将2015年10月至2019年12月期间主要诊断为ACS的所有索引住院病例，根据国际疾病分类第10版编码，按其DANCAMI评分进行分层。分析了30天内非计划再入院率及其原因，包括对与再入院相关因素的评估。多变量回归分析结果以调整优势比（aOR）及95%置信区间（95%CI）表示。
在2,066,328例ACS住院病例中，173,304例（8.4%）的DANCAMI评分为0，602,640例（29.2%）的DANCAMI评分为1 - 3，327,046例（15.8%）的DANCAMI评分为4 - 5，963,338例（46.6%）的DANCAMI评分≥6。189,240例（9.2%）在30天内有非计划再入院情况。DANCAMI评分较高的患者更可能年龄较大，且首次表现为非ST段抬高型ACS。DANCAMI评分≥6（aOR 1.30，95%CI 1.27 - 1.34）、年龄（aOR 1.01，95%CI 1.01 - 1.01）、女性（aOR 1.09，95%CI 1.08 - 1.10）、首次ST段抬高型ACS（aOR 1.03，95%CI 1.01 - 1.04）和心房颤动（aOR 1.35，95%CI 1.33 - 1.37）与再入院独立相关（所有p < 0.001）。评分越高，因非心血管原因再入院的可能性越大。
ACS患者DANCAMI评分升高与再入院率增加相关。DANCAMI评分可能是评估风险的一项有价值的工具。
