Key result
Repeated myocarditis readmissions drive cumulative post-discharge bed-days ~70% higher than first-return metrics alone.
Why the study?
Readmission metrics after acute myocarditis usually record only whether a first readmission occurs within 30 days, leaving the amount and duration of inpatient care received after the first return unknown.
Cohort (n=3,276)
Yes
After hospitalization for acute myocarditis, 41% of 6-month readmission bed-days and costs come from second and subsequent readmissions—mostly after 30 days and for non-myocarditis diagnoses—showing that standard 30-day first-readmission metrics understate the post-discharge inpatient burden by 1.7-fold.
Answers are grounded in this paper and cite their sources.
Standard 30-day metrics understate myocarditis readmission burden; challenges current benchmarks and leaves open optimal surveillance duration.
Background: Readmission metrics after acute myocarditis usually record only whether the first readmission occurs within 30 days. The amount of inpatient care received after the first return and the period over which it was received are unknown. Methods: We identified adults with a principal diagnosis of acute myocarditis (ICD-10-CM I40.x) in the Nationwide Readmission Database (NRD) from 2016 to 2022. The first qualifying admission in each patient year served as the index, and patients had to be discharged alive and not transferred. We linked every subsequent same-state, same-year admission for any cause within 30, 90, and 180 days. Using survey-weighted methods, we split the return length of stay (LOS) and estimated hospital cost (charges x cost-to-charge ratio, 2022 US dollars) into first-return and beyond-first-return components per index patient; patients without readmission were counted as having zero. The National Inpatient Sample (NIS) provided data on index mortality and costs. Results: Of the 3,276 sampled index patients eligible for the 180-day follow-up (5,897 for 30 days), 6.5% were readmitted within 30 days and 14.0% within 180 days. Over 180 days, readmissions added 1.51 (95% CI, 1.23?1.79) bed-days and $5,884 (95% CI, 4,352?7,417) per index patient. Readmissions after the first contributed 0.62 (0.42?0.82) days and $2,430 (1,599?3,262), which is 41% of return bed-days and 41% of return costs (95% CI, 34?49 and 33?49, respectively). Counting only the first readmission, therefore, understated the 180-day return burden by 1.7-fold. The beyond-first share rose from 10% at 30 days to 32% at 90 days and 41% at 180 days, and 63% of the 180-day return bed-days accrued after day 30. Most readmissions had a non-cardiovascular (55% of bed-days) or other cardiovascular (33%) principal diagnosis, and myocarditis accounted for 3.5%. In the NIS (2,964 admissions; 71 in-hospital deaths), survivors had a mean index LOS of 4.4 days and a mean cost of $23,867. Conclusions: After acute myocarditis, approximately two-fifths of the 6-month readmission bed-days and costs were from second and later readmissions. Most accrued after the usual 30-day window and were diagnoses other than myocarditis. First-readmission 30-day metrics substantially understate the post-discharge hospital burden in this population cohort.
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Sah et al. (2026) conducted a cohort in Acute myocarditis (n=3,276). Hospitalization for acute myocarditis (all readmissions vs first readmission only) vs. First readmission only within 180 days was evaluated on Cumulative 180-day readmission length of stay (bed-days per index patient) (Ratio 1.70 (41% beyond-first share), 95% CI 1.48-1.91). Readmissions after acute myocarditis added 1.51 bed-days and $5,884 per patient over 180 days, with 41% of days and costs occurring after the first readmission (1.7-fold higher than first-return metrics).
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