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Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis

BACKGROUND AND OBJECTIVES: Readmissions in heart failure (HF), historically reported as 20%, contribute to significant patient morbidity and high financial cost to the healthcare system. The changing population landscape and risk factor dynamics mandate periodic epidemiologic reassessment of HF read...

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Autores principales: Jain, Akhil, Arora, Shilpkumar, Patel, Viral, Raval, Maharshi, Modi, Karnav, Arora, Nirav, Desai, Rupak, Bozorgnia, Behnam, Bonita, Raphael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Heart Failure 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406555/
https://www.ncbi.nlm.nih.gov/pubmed/37554694
http://dx.doi.org/10.36628/ijhf.2023.0015
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author Jain, Akhil
Arora, Shilpkumar
Patel, Viral
Raval, Maharshi
Modi, Karnav
Arora, Nirav
Desai, Rupak
Bozorgnia, Behnam
Bonita, Raphael
author_facet Jain, Akhil
Arora, Shilpkumar
Patel, Viral
Raval, Maharshi
Modi, Karnav
Arora, Nirav
Desai, Rupak
Bozorgnia, Behnam
Bonita, Raphael
author_sort Jain, Akhil
collection PubMed
description BACKGROUND AND OBJECTIVES: Readmissions in heart failure (HF), historically reported as 20%, contribute to significant patient morbidity and high financial cost to the healthcare system. The changing population landscape and risk factor dynamics mandate periodic epidemiologic reassessment of HF readmissions. METHODS: National Readmission Database (NRD, 2019) was used to identify HF-related hospitalizations and evaluated for demographic, admission characteristics, and comorbidity differences between patients readmitted vs. those not readmitted at 30-days. Causes of readmission and predictors of all-cause, HF-specific, and non-HF-related readmissions were analyzed. RESULTS: Of 48,971 HF patients, the readmitted cohort was younger (mean 67.4 vs. 68.9 years, p≤0.001), had higher proportion of males (56.3% vs. 53.7%), lowest income quartiles (33.3% vs. 28.9%), Charlson comorbidity index (CCI) ≥3 (61.7% vs. 52.8%), resource utilization including large bed-size hospitalizations, Medicaid enrollees, mean length of stay (6.2 vs. 5.4 days), and disposition to other facilities (23.9% vs. 20%) than non-readmitted. Readmission (30-day) rate was 21.2% (10,370) with cardiovascular causes in 50.3% (HF being the most common: 39%), and non-cardiac in 49.7%. Independent predictors for readmission were male sex, lower socioeconomic status, nonelective admissions, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, anemia, and CCI ≥3. HF-specific readmissions were significantly associated with prior coronary artery disease and Medicaid enrollment. CONCLUSIONS: Our analysis revealed cardiac and noncardiac causes of readmission were equally common for 30-day readmissions in HF patients with HF itself being the most common etiology highlighting the importance of addressing the comorbidities, both cardiac and non-cardiac, to mitigate the risk of readmission.
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spelling pubmed-104065552023-08-08 Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis Jain, Akhil Arora, Shilpkumar Patel, Viral Raval, Maharshi Modi, Karnav Arora, Nirav Desai, Rupak Bozorgnia, Behnam Bonita, Raphael Int J Heart Fail Original Article BACKGROUND AND OBJECTIVES: Readmissions in heart failure (HF), historically reported as 20%, contribute to significant patient morbidity and high financial cost to the healthcare system. The changing population landscape and risk factor dynamics mandate periodic epidemiologic reassessment of HF readmissions. METHODS: National Readmission Database (NRD, 2019) was used to identify HF-related hospitalizations and evaluated for demographic, admission characteristics, and comorbidity differences between patients readmitted vs. those not readmitted at 30-days. Causes of readmission and predictors of all-cause, HF-specific, and non-HF-related readmissions were analyzed. RESULTS: Of 48,971 HF patients, the readmitted cohort was younger (mean 67.4 vs. 68.9 years, p≤0.001), had higher proportion of males (56.3% vs. 53.7%), lowest income quartiles (33.3% vs. 28.9%), Charlson comorbidity index (CCI) ≥3 (61.7% vs. 52.8%), resource utilization including large bed-size hospitalizations, Medicaid enrollees, mean length of stay (6.2 vs. 5.4 days), and disposition to other facilities (23.9% vs. 20%) than non-readmitted. Readmission (30-day) rate was 21.2% (10,370) with cardiovascular causes in 50.3% (HF being the most common: 39%), and non-cardiac in 49.7%. Independent predictors for readmission were male sex, lower socioeconomic status, nonelective admissions, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, anemia, and CCI ≥3. HF-specific readmissions were significantly associated with prior coronary artery disease and Medicaid enrollment. CONCLUSIONS: Our analysis revealed cardiac and noncardiac causes of readmission were equally common for 30-day readmissions in HF patients with HF itself being the most common etiology highlighting the importance of addressing the comorbidities, both cardiac and non-cardiac, to mitigate the risk of readmission. Korean Society of Heart Failure 2023-06-01 /pmc/articles/PMC10406555/ /pubmed/37554694 http://dx.doi.org/10.36628/ijhf.2023.0015 Text en Copyright © 2023. Korean Society of Heart Failure https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jain, Akhil
Arora, Shilpkumar
Patel, Viral
Raval, Maharshi
Modi, Karnav
Arora, Nirav
Desai, Rupak
Bozorgnia, Behnam
Bonita, Raphael
Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title_full Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title_fullStr Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title_full_unstemmed Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title_short Etiologies and Predictors of 30-Day Readmission in Heart Failure: An Updated Analysis
title_sort etiologies and predictors of 30-day readmission in heart failure: an updated analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406555/
https://www.ncbi.nlm.nih.gov/pubmed/37554694
http://dx.doi.org/10.36628/ijhf.2023.0015
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