One in five who experience a myocardial infarction (MI) will be back in the hospital within a month. Researchers from the Cleveland Clinic evaluated the risk of readmission cause by MI to understand when and why patients are at risk for readmission to control costs and improve care.

Published online Aug. 14 in the Journal of the American College of Cardiology, the cohort study included 3,069 patients discharged after an MI. Of the 494 readmissions, 47 percent (232) were related to MI or other cardiovascular issue. Furthermore, 39 percent (191) occurred within 15 days.

“The risk of readmission after MI was highest immediately after discharge, particularly for CV-related readmissions and dropped by almost one-half within 15 days of discharge,” wrote lead author Umesh N. Khot, MD, with the Cleveland Clinic’s Heart and Vascular Institute Center for Healthcare Delivery Innovation, and colleagues. “Efforts to prevent readmission need to account for this change in risk over time and prevention strategies should begin early during the index admission.”

The team’s study contrasted previous work that claimed readmissions after MI didn’t vary over time. Khot et al. found risk and cause of readmission did change. Non-cardiovascular-related readmissions are especially challenging to address, because they require collaboration with other specialists.

“A more nuanced approach based on the risk and cause of readmission over time might be a more preferred method to improve quality of MI care and to hold hospitals accountable for readmissions after MI,” wrote Khot and colleagues.