Factors influencing early hospital readmissions and return to work after STEMI: lessons from the Lausanne STEMI network


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A Master's thesis.
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Master (thesis) (master)
Factors influencing early hospital readmissions and return to work after STEMI: lessons from the Lausanne STEMI network
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Université de Lausanne, Faculté de biologie et médecine
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Primary PCI (percutaneous coronary intervention) is the mainstream therapy for patients suffering from STEMI (ST-elevation myocardial infarction) [1,2]. No definite answer about factors predicting early readmission (<30 days) and return to work in patient undergoing primary PCI have been provided by previous research. Moreover, return to work delay and return to work rate after PCI is currently unknown in our country. In the following paper we would provide additional data from a tertiary university hospital in Switzerland.
We have analyzed retrospectively medical charts of 1076 patients who underwent primary PCI for STEMI in a large tertiary hospital in Switzerland. Early readmission rate and return to work rate were evaluated for the following factors: gender, age at operation, cardiovascular risk factors and comorbidities. Main additional inclusion criterion was age <65 at operation time. Exclusion criteria were dataframe incomplete for more than 3
variables, and for the prospective part of the study, being unemployed prior to the procedure. Finally, a total of 285 patients met the criteria to be included in the study.
We have found that 4.21% of our patients were early readmitted (<30 days) following initial discharge after PCI. No risk factor taken into account was significatively different between the early readmitted and non-early readmitted group. We have also observed a 95.65% return to work rate, and an average sick leave of 2.07 (SD = 1.16) months. Our data show that female sex, concomitant peripheric artery disease and concomitant hepatic failure were significantly different between return to work and non-return to work group.
In this paper we found a sensibly lower readmission rate and a higher return to work rate than previously reported. Moreover, we were able to observe a significant difference among return to work and not return to work groups suggesting that female sex, concomitant peripherical artery disease and concomitant hepatic failure could be associated with an unsuccessful return to work. However, reasonably due to a lack of statistical power we failed to provide definitive answers about factors influencing early readmission and return to work on the basis of sociodemographic data and comorbidities. Finally, we’ve managed to provide data on return to work delay and percentage in Switzerland, who were previously unknown.
ST-segment elevation myocardial infarction, percutaneous coronary intervention, early hospital readmission, return to work
Create date
07/09/2020 11:45
Last modification date
23/02/2021 7:26
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