Despite a younger age, Black participants hospitalized with acute MI (AMI) have a more geriatric phenotype, according to a study published in the Journal of the American Geriatrics Society. Patrick C. Demkowicz, MD-candidate, and colleagues analyzed data from patients aged 75 or older who were hospitalized for AMI to examine racial disparities in aging-specific functional impairments and mortality. Among 2,918 participants, 91.4% self-identified as White and 8.6% self-identified as Black. Black participants were
younger and more likely to be female. The likelihood of presenting with impairments in cognition, mobility, and vision was significantly increased among Black individuals, who were also more likely to report a disability in one or more activities of daily living and an unintentional loss of more than 10 pounds in the year before hospitalization. Black participants had an unadjusted OR for 6-month mortality of 2.0 (95% CI, 1.4-2.8), which was attenuated after adjustment for age and clinical characteristics (OR, 1.7; 95% CI, 1.2-2.5) and became non-significant after adjustment for functional/geriatric conditions (OR, 1.5; 95% CI, 1.0-2.2).
EHR Data Can Predict Readmission in Children
A risk prediction model may identify infants and children at risk for hospital readmission, according to a study published in JAMA Network Open. Denise M. Goodman, MD, and colleagues developed and validated a tool for identifying patients before hospital discharge who are at risk for subsequent readmission for all ages. The derivation set was based on 29,988 patients (48,019 hospitalizations). Among children aged 6 months and older with one or more prior hospitalizations within the last 6 months (recent admission), prior utilization, current or prior procedures indicating illness severity (transfusion, ventilation, or central venous catheter), commercial insurance, and prolonged length of stay (LOS) were associated with readmission. Among children older than 6 months with no prior hospitalizations in the last 6 months (new admission), procedures, prolonged LOS, and an ED visit in the past 6 months were associated with reduced readmission. Among children younger than 6 months (young infants), LOS, prior visits, and critical procedures were associated with readmission. “These models may allow future improvements in tailored discharge preparedness to prevent high-risk readmissions,” Dr. Goodman and colleagues wrote.