Clinical outcomes and 30-day readmissions for heart failure with reduced ejection fraction with cardiorenal syndrome: A National Cohort Study

Layla Shanah; Tanveer Mir; Mohammed M Uddin; Tanveer Hussain; Tilachan Parajuli; Zeenat Bhat

doi:10.1016/j.ijcard.2022.10.161

$Clinical outcomes and 30-day readmissions for heart failure with reduced ejection fraction with cardiorenal syndrome: A National Cohort Study$

Journal article

Peer reviewed

Clinical outcomes and 30-day readmissions for heart failure with reduced ejection fraction with cardiorenal syndrome: A National Cohort Study

Layla Shanah, Tanveer Mir, Mohammed M Uddin, Tanveer Hussain, Tilachan Parajuli and Zeenat Bhat

International journal of cardiology, Vol.370, pp.244-249

01/01/2023

DOI: 10.1016/j.ijcard.2022.10.161

PMID: 36328112

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Abstract

Literature regarding outcomes of cardiorenal syndrome (CRS) among heart failure with reduced ejection fraction (HFrEF) is limited. To study the clinical outcomes and 30-day readmission rates of CRS patients with HFrEF. Data from the Nationwide Readmissions Database (NRD) that constitutes 49.1% of the stratified sample of all hospitals in the United States (US), representing >95% of the national population, was analyzed for the CRS with HFrEF visits from 2018 to 2019. CRS was defined by the ICD-10 codes. Out of the 1,530,749 index CRS-related hospitalizations (mean age:64.37 ± 13.30 years; 38.6%females) 73,126 (6.0%) CKD I-II, 883,119 (72.6%) CKD III-IV, and 258,835 (21.3%) CKD V-and-more related encounters were recorded. Mortality was higher among CKD stage V-and-more in comparison to other subgroups(7.6%vs5.73%;p < 0.001). AKI with underlying CKD was more common among stage III-IV compared to other subgroups (55.9%vs43.7%;p < 0.001). Respiratory failure, the second major complication, was more common among stage V-and-more compared to other subgroups (32.5%vs30%;p < 0.001). The overall CRS-related 30-day readmission rate was 22.7%, with CKD V-and-more accounting for highest rates(29.89%), followed by CKD stage III-IV(20.05%) and CKD I-II(12.99%). The primary etiology for 30-day readmission was cardiovascular among all subgroups (54.2%, 54.6%, and 41.80%, which corresponds to CKD I-II, CKD III-IV and CKD V-and-more, respectively). CRS among HFrEF accounts for substantial healthcare burden with high 30-day readmission rates. Higher all-cause mortality and 30-day readmissions were associated with worse renal disease. This would suggest that more vigilance is needed by physicians for discharge planning among this patient population.

Aged

Cardio-Renal Syndrome - diagnosis

Cardio-Renal Syndrome - epidemiology

Cardio-Renal Syndrome - therapy

Cohort Studies

Female

Heart Failure - diagnosis

Heart Failure - epidemiology

Heart Failure - therapy

Humans

Middle Aged

Patient Readmission

Renal Insufficiency, Chronic - diagnosis

Renal Insufficiency, Chronic - epidemiology

Renal Insufficiency, Chronic - therapy

Risk Factors

Stroke Volume

United States - epidemiology

Details

Title: Subtitle: Clinical outcomes and 30-day readmissions for heart failure with reduced ejection fraction with cardiorenal syndrome: A National Cohort Study
Creators: Layla Shanah - Wayne State University
Tanveer Mir - Wayne State University
Mohammed M Uddin - Wayne State University
Tanveer Hussain - Wayne State University
Tilachan Parajuli - Brookwood Baptist Health
Zeenat Bhat - University of Michigan
Resource Type: Journal article
Publication Details: International journal of cardiology, Vol.370, pp.244-249
DOI: 10.1016/j.ijcard.2022.10.161
PMID: 36328112
NLM abbreviation: Int J Cardiol
ISSN: 0167-5273
eISSN: 1874-1754
Language: English
Date published: 01/01/2023
Academic Unit: Internal Medicine
Record Identifier: 9985013727202771

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