Advertisement

Journal of General Internal Medicine

, Volume 34, Issue 4, pp 486–488 | Cite as

Trends, Management Patterns, and Predictors of Leaving Against Medical Advice among Patients with Documented Noncompliance Admitted for Acute Myocardial Infarction

  • Gbolahan O. OgunbayoEmail author
  • Tara A. Shrout
  • Naoki Misumida
  • Ahmed Abdel-Latif
  • Susan S. Smyth
  • Adrian W. Messerli
  • Khalid M. Ziada
Concise Research Reports

INTRODUCTION

Noncompliance (NC) and leaving against medical advice (LAMA) are risk factors for poor outcomes, including hospital readmission and mortality.1,2 This study aims to investigate the relationship between NC and LAMA, describe characteristics of NC patients, evaluate the clinical management of acute myocardial infarction (AMI) in NC patients, and identify predictors of LAMA in this population. We hypothesized that NC would be associated with higher rates of LAMA.

METHODS

We identified adults with a primary diagnosis of AMI and documented NC using the National Inpatient Survey (2010–2014). Documented NC is defined by the ICD-9-CM Diagnosis Code V15.81 as a personal history of noncompliance with medical treatment, presenting hazards to health. We used logistic regression to perform temporal trend analysis for documented NC among patients with a primary diagnosis of AMI. We then compared demographic and clinical characteristics as well as outcomes, primarily LAMA, between this...

KEY WORDS

noncompliance high-risk patients leaving against medical advice (LAMA) acute myocardial infarction (AMI) 

References

  1. 1.
    Fiscella K, Meldrum S, Barnett S. Hospital Discharge against Advice after Myocardial Infarction: Deaths and Readmissions. Am J Med. 2007;120(12):1047–1053.  https://doi.org/10.1016/j.amjmed.2007.08.024
  2. 2.
    Garland A, Ramsey CD, Fransoo R, Olafson K, Chateau D, Yogendran M, Kraut A. Rates of readmission and death associated with leaving hospital against medical advice: A population-based study. Can Med Assoc J. 2013.  https://doi.org/10.1503/cmaj.130029
  3. 3.
    Jeremiah J, O’Sullivan P, Stein M. Who leaves against medical advice? J Gen Intern Med. 1995;10(7):403–405.  https://doi.org/10.1007/BF02599843
  4. 4.
    Ibrahim SA, Kwoh CK, Krishnan E. Factors associated with patients who leave acute-care hospitals against medical advice. Am J Public Health. 2007;97(12):2204–2208.  https://doi.org/10.2105/AJPH.2006.100164
  5. 5.
    Gargiulo G, Windecker S, da Costa BR, Feres F, Hong MK, Gilard M, Kim HS, Colombo A, Bhatt DL, Kim BK, Morice MC, Park KW, Chieffo A, Palmerini T, Stone GW, Valgimigli M. Short term versus long term dual antiplatelet therapy after implantation of drug eluting stent in patients with or without diabetes: systematic review and meta-analysis of individual participant data from randomised trials. BMJ. 2016:i5483.  https://doi.org/10.1136/bmj.i5483.
  6. 6.
    Alfandre D. Reconsidering against medical advice discharges: Embracing patient-centeredness to promote high quality care and a renewed research agenda. J Gen Intern Med. 2013.  https://doi.org/10.1007/s11606-013-2540-z

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Gbolahan O. Ogunbayo
    • 1
    • 2
    Email author
  • Tara A. Shrout
    • 1
    • 2
  • Naoki Misumida
    • 1
  • Ahmed Abdel-Latif
    • 1
  • Susan S. Smyth
    • 1
  • Adrian W. Messerli
    • 1
  • Khalid M. Ziada
    • 1
  1. 1.University of Kentucky Medical CenterLexingtonUSA
  2. 2.Division of Cardiovascular Medicine, The Gill Heart and Vascular Institute University of KentuckyLexingtonUSA

Personalised recommendations