Readmission-Free Period and In-Hospital Mortality at the Time of First Readmission in Acute Heart Failure Patients
Introduction: Heart Failure (HF) is the most common cause of hospital readmission in the USA with annual readmission costs of $2 Billion. Historically, readmissions were associated with poor health outcomes and been a primary focus for policymakers.
Hypothesis: Readmission-free period (RFP) between an index HF admission and the subsequent readmission is an important marker to identify HF patients at high mortality risk. Shorter RFP correlates with significantly higher mortality.
Methods: We identified 75,410 index admission with Acute HF in the 2014 Nationwide Readmission Database. We excluded patients < 18 years, died during an index admission, same-day readmission, and patients with missing length of stay (LOS). Only patients with ≥1 readmission within 9 months were included. In-patient mortality, LOS, and RFP were calculated.
Results:A total of 39,248 patients met inclusion criteria. Cases were divided into three groups: Readmitted (i) within 30 days: 15,181 patients, (ii) within 31-90 days: 11,925 patients, (iii) >90 days: 12,131 patients. Median age was 64 years, 48% were females. In-hospital mortality was higher in patients admitted within 30 days (7.4% in Group 1 vs. 5.1% and 4.1% in Groups 2 and 3); p
Conclusions: The length between index heart failure admission and the first readmission inversely correlates with in-hospital mortality. RFP might be utilized as a maker to identify the subset of heart failure patients at higher mortality risk upon readmission.
Published In/Presented At
Altibi, A. M., Prousi, G. Shah, M. Agarwal, M. Ram, P. Tripathi, B. K., Patil, S. Patel, B. (2019, November). Readmission-Free Period and In-Hospital Mortality at the Time of First Readmission in Acute Heart Failure Patients. Circulation. 2019;140:A15477.
Department of Medicine, Department of Medicine Faculty, Department of Medicine Fellows and Residents