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Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study

BACKGROUND: Short-term hospital readmissions for acute heart failure lead to the rise of health care budget and all-cause death. Elderly patients with acute or decompensated heart failure are often admitted to different wards (either the geriatric department or other departments). The diagnosis for...

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Autores principales: Zhao, Zhiying, Wang, Wenyan, Jin, Jing, Liu, Xuemei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186253/
https://www.ncbi.nlm.nih.gov/pubmed/35693607
http://dx.doi.org/10.21037/jtd-22-433
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author Zhao, Zhiying
Wang, Wenyan
Jin, Jing
Liu, Xuemei
author_facet Zhao, Zhiying
Wang, Wenyan
Jin, Jing
Liu, Xuemei
author_sort Zhao, Zhiying
collection PubMed
description BACKGROUND: Short-term hospital readmissions for acute heart failure lead to the rise of health care budget and all-cause death. Elderly patients with acute or decompensated heart failure are often admitted to different wards (either the geriatric department or other departments). The diagnosis for readmission, cost and length of hospital stay in different wards are not well known. METHODS: A retrospective study was conducted examining senile patients admitted to the hospital over a 1-year period. Data related to demographic information, comorbidities, ejection fraction (EF), brain natriuretic peptide (BNP) levels, costs, and discharge disposition were collected from electronic medical record. RESULTS: A total of 3,922 cases were enrolled in this study. There were 1,316 patients with heart failure who were re-hospitalized, among which, 893 were admitted to the geriatric department. The top 3 diagnosis for re-hospitalization for more than 7 days in the geriatric department were pneumonia (38.5%), blood pressure fluctuations (19.4%), and acute coronary syndrome (ACS) (13.3%). The factors for readmission to other departments were pneumonia (32.5%), arrhythmia (17.7%), and blood pressure fluctuations (15.5%). The top 3 diagnosis for rehospitalizations lasting 7 days or less in the geriatric department were blood pressure fluctuations (26.5%), arrhythmia (23.4%), and fatigue or stress (16.9%), while ACS (24.1%), blood pressure fluctuations (22.5%), and arrhythmia (14.7%) were the top 3 diagnosis for other departments. The geriatric department tended to receive more senile patients, with lower BNP levels (625.13±823.71 vs. 929.31±873.38 pg/mL), and longer duration of hospitalization (24.38±5.228 vs. 15.65±5.907 days). However, there was no significant difference in the total cost of admission between geriatric department and other departments ($4,483 vs. $4,415, P=0.129). CONCLUSIONS: Our study identified a higher readmission rate in senile acute decompensated heart failure patients. Pneumonia was listed as the top 1 diagnosis for longer hospital stay in different department. Those rehospitalized with pneumonia may benefit from geriatric department.
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spelling pubmed-91862532022-06-11 Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study Zhao, Zhiying Wang, Wenyan Jin, Jing Liu, Xuemei J Thorac Dis Original Article BACKGROUND: Short-term hospital readmissions for acute heart failure lead to the rise of health care budget and all-cause death. Elderly patients with acute or decompensated heart failure are often admitted to different wards (either the geriatric department or other departments). The diagnosis for readmission, cost and length of hospital stay in different wards are not well known. METHODS: A retrospective study was conducted examining senile patients admitted to the hospital over a 1-year period. Data related to demographic information, comorbidities, ejection fraction (EF), brain natriuretic peptide (BNP) levels, costs, and discharge disposition were collected from electronic medical record. RESULTS: A total of 3,922 cases were enrolled in this study. There were 1,316 patients with heart failure who were re-hospitalized, among which, 893 were admitted to the geriatric department. The top 3 diagnosis for re-hospitalization for more than 7 days in the geriatric department were pneumonia (38.5%), blood pressure fluctuations (19.4%), and acute coronary syndrome (ACS) (13.3%). The factors for readmission to other departments were pneumonia (32.5%), arrhythmia (17.7%), and blood pressure fluctuations (15.5%). The top 3 diagnosis for rehospitalizations lasting 7 days or less in the geriatric department were blood pressure fluctuations (26.5%), arrhythmia (23.4%), and fatigue or stress (16.9%), while ACS (24.1%), blood pressure fluctuations (22.5%), and arrhythmia (14.7%) were the top 3 diagnosis for other departments. The geriatric department tended to receive more senile patients, with lower BNP levels (625.13±823.71 vs. 929.31±873.38 pg/mL), and longer duration of hospitalization (24.38±5.228 vs. 15.65±5.907 days). However, there was no significant difference in the total cost of admission between geriatric department and other departments ($4,483 vs. $4,415, P=0.129). CONCLUSIONS: Our study identified a higher readmission rate in senile acute decompensated heart failure patients. Pneumonia was listed as the top 1 diagnosis for longer hospital stay in different department. Those rehospitalized with pneumonia may benefit from geriatric department. AME Publishing Company 2022-05 /pmc/articles/PMC9186253/ /pubmed/35693607 http://dx.doi.org/10.21037/jtd-22-433 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Zhao, Zhiying
Wang, Wenyan
Jin, Jing
Liu, Xuemei
Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title_full Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title_fullStr Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title_full_unstemmed Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title_short Diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
title_sort diagnosis for readmission of senile patients hospitalized with acute decompensated heart failure in different departments: a retrospective cross-sectional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186253/
https://www.ncbi.nlm.nih.gov/pubmed/35693607
http://dx.doi.org/10.21037/jtd-22-433
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