READMITS Score for 30-Day Readmission Risk in Acute MI
Predicts 30-day all-cause hospital readmission after acute myocardial infarction (AMI) discharge. Validated to identify high-risk patients for intensive post-discharge follow-up and care transition support.
Score interpretation
READMITS 0-3 -- low readmission risk; standard post-AMI discharge plan
→ Standard post-AMI discharge: DAPT + beta-blocker + ACEi/ARB (or ARNI if EF <= 40%) + statin + SGLT2 inhibitor; GP follow-up in 2 weeks; outpatient cardiology in 6-8 weeks; cardiac rehabilitation referral; written medication reconciliation list; discharge summary to GP same day; BNP/echo if EF not known; 24-hour helpline contact details.
READMITS 4-7 -- moderate risk; enhanced discharge planning and early follow-up
→ Early cardiology outpatient review in 1-2 weeks; community cardiac nurse referral; medication reconciliation by pharmacist before discharge; identify modifiable factors: optimise anaemia (iron supplements if iron-deficient), diabetes control (SGLT2 inhibitor HbA1c targets), renal monitoring (avoid nephrotoxins, ACEi dose titration); cardiac rehabilitation priority referral; early warning signs education (chest pain, breathlessness, leg swelling); discharge letter flagged as high-risk to GP; phone follow-up at 48-72 hours post-discharge.
READMITS >= 8 -- high readmission risk; intensive transitional care interventions required
→ Dedicated heart failure/transitional care team review before discharge; complex discharge planning: social work involvement, home care assessment, medication dosette box/compliance aids; community matron or specialist nurse home visit within 48-72 hours of discharge; telemedicine/remote monitoring (weight, BP, HR) if available; post-AMI clinic within 5-7 days; target modifiable predictors: refer to anaemia clinic for IV iron; refer to diabetes specialist for HbA1c optimisation; ensure beta-blocker prescribed (evidence-based -- reduce mortality); document READMITS score and plan in discharge summary; ICB/CCG notification for care coordination funding if applicable.
Interpretation bands for the READMITS Score. Apply clinical judgement and local guidance.
References
- Chin CT et al. Readmission Rates and Costs after Acute Myocardial Infarction. J Am Heart Assoc. 2011;1(1):e000132.
- NICE NG185. Acute coronary syndromes: secondary prevention and rehabilitation. NICE. 2020.
Related
Curated clinical cross-links plus same-class fallbacks.
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Lisinopril (HFrEF / Post-MI) · ACE Inhibitor / HFrEF
- Clopidogrel (ACS / Post-PCI) · Antiplatelet / ACS
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.