READMITS Score for Readmissions in Acute MI
Why Use
May be useful from an administrative standpoint. Early identification of patients at increased risk of 30-day readmission allows clinicians to implement targeted readmission reduction interventions (e.g. transition of care programs) for those patients. Compared to alternative acute MI risk prediction models, such as the Centers for Medicare and Medicaid Services (CMS) acute MI model, the Acute MI READMITS Score has demonstrated improved accuracy in identifying high-risk patients, and is more readily calculated in the clinical setting.
When to Use
Adult patients (≥18 years old) presenting with acute MI.
Formula
Pearls / Pitfalls
The Acute MI READMITS Score was developed to identify patients at increased risk of early hospital readmission. Calculated using seven clinical and laboratory variables routinely available to clinicians during the first 24 hours of admission. Based on EHR data and not yet externally validated. There is a modest overestimation of readmission risk in the highest and lowest quintiles.
Management
Readmission risk was strongly associated with clinical measures of severity. Therefore, early implementation of guideline-recommended acute MI treatments (i.e., early coronary intervention) likely plays an important role in preventing 30-day readmissions.
Advice
Should be calculated on the first day of hospital admission (model was designed so that all the required parameters would be available during the first 24 hours of hospital admission). Patients identified as high-risk are most likely to benefit from targeted readmission reduction interventions (e.g. transition of care programs, which may include components such as reading materials, outpatient follow-up appointment scheduled prior to discharge, and others). Readmission reduction interventions are most effective when implemented early in a patient’s hospital course.
More Information
Interpretation: READMITS Score Risk group 30-day readmission risk ≤13 Extremely low 2% 14-15 Low 8% 16-17 Moderate 9% 18-19 High 17% ≥20 Extremely high 34% From Nguyen 2018 .