Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States

JACC. Cardiovascular Interventions
Chun Shing KwokMamas A Mamas

Abstract

This study aimed to evaluate discharge against medical advice (DAMA) in percutaneous coronary intervention (PCI) and how DAMA affects readmissions. DAMA is infrequent but associated with poor patient outcomes. DAMA in the context of PCI has not been described in the published reports. The authors analyzed patients in the Nationwide Readmission Database between 2010 and 2014 with a PCI procedure who were either discharged home or against medical advice. The primary endpoint was all-cause 30-day readmissions and their causes. Descriptive statistics were used to compare DAMA with patients discharged home, and multiple logistic regressions were used to determine patient characteristics associated with DAMA and readmission. Among the 2,021,104 patients in the analysis, the proportion of patients who DAMA was 0.5% (n = 10,049). The 30-day readmission rate for patients who were DAMA and those discharged home was 16.8% and 8.5%, respectively (p < 0.001). Important predictors of DAMA included diagnosis of acute myocardial infarction (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.25 to 1.51; p < 0.001), smoking (OR: 1.71; 95% CI: 1.57 to 1.86; p < 0.001), drug abuse (OR: 1.82; 95% CI: 1.60 to 2.06; p < 0.001), and alcohol misuse...Continue Reading

Citations

Feb 29, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Chun Shing KwokMamas A Mamas
May 4, 2020·Digestive Diseases and Sciences·Olalekan AkanbiPraneeth Kudaravalli
Jun 4, 2019·JAMA Internal Medicine·Sameer Prakash, M Tarek Naguib
Nov 7, 2019·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Sri Lekha TummalapalliEric R Goodlev
Mar 7, 2020·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Eberechukwu OnukwughaDavid Alfandre
May 18, 2019·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Rahul A Pandit, Atul P Kulkarni
Mar 17, 2021·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·David AlfandreEberechukwu Onukwugha

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