A-1 | Effect of Hospital Teaching Status on the Myocardial Infarction Complications

Teaching hospitals are associated with better outcomes than non-teaching hospitals for patients hospitalized for acute myocardial infarction (AMI). Data on AMI complications as a function of hospital teaching status remains limited. This study evaluates if teaching status predicts AMI cardiac complications within 28 days of admission. This retrospective cohort study utilized the 2020 Nationwide Inpatient Sample to study the complications within 28 days of admission in patients admitted to teaching vs. non-teaching hospitals for AMI. Multivariate linear and logistic regression models were used to adjust for demographics, Charleston comorbidity index, and hospital factors. This study included 567,989 patients admitted for AMI. Among those admitted with a primary diagnosis of AMI, the mean age was 56; 63% were males, 73% were white, and 57% were insured by Medicare. 0.57% of patients admitted for AMI had a secondary diagnosis of post-AMI complications, including hemopericardium, septal defects, rupture of cardiac structures, and intra-cardiac thrombi formation within 28 days of admission. The incidence of mechanical complications was higher in teaching hospitals compared to non-teaching hospitals (78% vs. 22%, p < 0.01), and the mean length of stay was extended in teaching hospitals for patients admitted for AMI (4.5 days vs. 3.5 days). Patients with AMI admitted to teaching hospitals were more likely to have AMI complications within 28 days and longer hospitalization stays than patients admitted with AMI in non-teaching hospitals. Though this study controlled for known confounders, the degree of illness in teaching hospitals may be an unmeasured confounder and should be addressed in future investigations.