Loneliness and Risk of 30-Day Hospital Readmission After Acute Myocardial Infarction.

Background: Poor social health is linked to incident cardiovascular disease, but less is known about how loneliness affects health care utilization after an acute myocardial infarction (AMI).

Objective: Determine the association between loneliness and 30-day emergency department (ED) visit or readmission after AMI hospitalization.

Research design: The REasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national prospective cohort of 30,239 U.S. adults aged 45 years or older.

Measures: We examined the association between loneliness and 30-day post-AMI ED visit or readmission.

Subjects: Seven hundred forty-nine Medicare fee-for-service beneficiaries in REGARDS were discharged alive after an adjudicated AMI.

Results: The mean age was 77 years. Twenty-eight percent self-identified as non-Hispanic Black and 39% as women. Twenty percent reported loneliness. Twenty-nine percent had a 30-day ED visit or readmission. Lonely individuals had 61% increased risk of 30-day ED visit or readmission (RR: 1.61; 95% CI: 1.27-2.04; P<0.001), which remained significant after adjustment for sociodemographic and clinical factors (aRR: 1.48; 95% CI: 1.12-1.95; P=0.006). Stratified analyses demonstrated significant association for those aged 65-74 (aRR 2.48; 95% CI, 1.57-3.91; P<0.001), White adults (aRR: 1.86; 95% CI: 1.35-2.58; P<0.001), and men (aRR: 2.19; 95% CI: 1.59-3.01; P<0.001) but not for those 75+ (aRR: 0.94; 95% CI: 0.63-1.40; P=0.75), Black adults (aRR: 0.89; 95% CI: 0.53-1.49; P=0.660), or women (aRR: 0.81; 95% CI: 0.51-1.30; P=0.380).

Conclusions: Loneliness, even measured years before AMI, was associated with an increased risk of 30-day ED visit or readmission, specifically for those aged 65-74, White participants, and men. These findings may inform discharge strategies to reduce readmissions.