Discharge against medical advice after PCI is “infrequent but fatal”



According to a new study published in JACC: Cardiovascular Interventions.

The researchers, led by Mamas A. Mamas, BMBCh, DPhil, from Keele University in Staffordshire, UK, said that although DAMA occurs in less than 1% of patients after PCI in particular , this is the best predictor of unplanned 30-day myocardial readmissions. patients with heart attack (MI).

“[DAMA] refers to patients who leave the hospital before the attending physician recommends their discharge, ”wrote Mamas and colleagues. “This poses a problem for physicians treating inpatients and it has been noted that it occurs in 1% to 2% of all medical admissions. Certain groups within the general population, such as those with mental health problems, are more likely to experience ADAM. Other factors that predict DAMA include self-financing of health care, Medicaid insurance, and being young and masculine. “

Researchers looked at the rates, trends, and predictors of DAMA patients and assessed the causes and readmission rates of DAMA patients.

The authors analyzed more than two million adult patients in the Nationwide Readmission Database (NRD), a publicly available database of paid hospital stays in the United States who underwent PCI between 2010 and 2014. The patients investigated by the researchers were advice or discharge approved by a doctor.


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