A-39 | Causes and Predictors of Thirty-Day Readmission in Patients with Acute Myocardial Infarction and Co-Existing Cirrhosis: National Readmission Database 2020 Analysis

Acute Myocardial Infarction (AMI) is a life-threatening condition that has high morbidity and mortality, especially in patients with co-existing cirrhosis. We aimed to study the rates, causes and predictors of readmission in patients with AMI and cirrhosis. The National Readmission Database for 2020 was analyzed to identify patients with AMI and co-existing cirrhosis. Multivariate logistic and linear regression analysis were used to adjust for possible confounders. 3,307 patients with AMI and co-diagnosis of cirrhosis were identified, of which 3,014 were discharged alive. Within 30 days from discharge, 1,898 (38.7%) were readmitted. Those readmitted had a shorter length of stay (LOS) and had Medicare and Medicaid as insurance while having similar age, sex, hospital characteristics, and household income status. Readmissions lead to an additional mean total hospital charge (THC) of $89,618 and a mean length of stay (LOS) of 6.2 days. The top five causes of readmissions were sepsis (7.1%), heart failure with chronic kidney disease stage 1-4 (6.1%), non-ST segment myocardial infarction (4.8%), hypertensive heart disease with heart failure (3.8%), and hepatic failure without coma (2.3%). Figure 1 shows the forest plot of a multivariate analysis of independent factors associated with readmissions. 30-day readmission rate was high (38.7%) in patients with AMI and co-existing cirrhosis. Predictors included discharge against medical advice and anemia. Better optimization of management plan to address predictors and causes of readmission is needed to improve outcomes.