Journal article
Etiologies, Trends, and Predictors of 30-Day Readmission in Patients With Heart Failure
The American journal of cardiology, Vol.119(5), pp.760-769
03/01/2017
DOI: 10.1016/j.amjcard.2016.11.022
PMID: 28109560
Abstract
Heart failure (HF) is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions, increasing attention to potential ways to address the problem. The study cohort was derived from the Healthcare Cost and Utilization Project's National Readmission Data 2013, sponsored by the Agency for Healthcare Research and Quality. HF was identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes. Readmission was defined as a subsequent hospital admission within 30 days after discharge day of index admission. Readmission causes were identified using International Classification of Diseases, Ninth Revision, codes in primary diagnosis filed. The primary outcome was 30-day readmission. Hierarchical 2-level logistic models were used to evaluate study outcomes. From a total 301,892 principal admissions (73.4% age ≥65 years and 50.6% men), 55,857 (18.5%) patients were readmitted with a total of 64,264 readmissions during the study year. Among the etiologies of readmission, cardiac causes (49.8%) were most common (HF being most common followed by coronary artery disease and arrhythmias), whereas pulmonary causes were responsible for 13.1% and renal causes for 8.9% of the readmissions. Significant predictors of increased 30-day readmission included diabetes (odds ratio, 95% confidence interval, p value: 1.06, 1.03 to 1.08, p <0.001), chronic lung disease (1.13, 1.11 to 1.16, p <0.001), renal failure/electrolyte imbalance (1.12, 1.10 to 1.15, p <0.001), discharge to facilities (1.07, 1.04 to 1.09, p <0.001), lengthier hospital stay, and transfusion during index admission. In conclusion, readmission after a hospitalization for HF is common. Although it may be necessary to readmit some patients, the striking rate of readmission demands efforts to further clarify the determinants of readmission and develop strategies in terms of quality of care and care transitions to prevent this adverse outcome.
Details
- Title: Subtitle
- Etiologies, Trends, and Predictors of 30-Day Readmission in Patients With Heart Failure
- Creators
- Shilpkumar Arora - Department of Internal Medicine, Mount Sinai St Luke's-Roosevelt Hospital, New York, New York. Electronic address: dr.shilparora@yahoo.comPrashant Patel - Cardiology Department, University of Southern California, Los Angeles, CaliforniaSopan Lahewala - Department of Internal Medicine, RWJ Barnabas Health/Jersey City Medical Center, Jersey City, New JerseyNilay Patel - Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, New JerseyNileshkumar J Patel - Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FloridaKosha Thakore - Department of Internal Medicine, Mount Sinai St Luke's-Roosevelt Hospital, New York, New YorkAditi Amin - Department of Internal Medicine, Mount Sinai St Luke's-Roosevelt Hospital, New York, New YorkByomesh Tripathi - Department of Internal Medicine, Mount Sinai St Luke's-Roosevelt Hospital, New York, New YorkVarun Kumar - Department of Internal Medicine, Mount Sinai St Luke's-Roosevelt Hospital, New York, New YorkHarshil Shah - Cardiology Department, Detroit Medical Center, Detroit, MichiganMahek Shah - Department of Internal Medicine, Lehigh Valley Hospital, Allentown, PennsylvaniaSidakpal Panaich - Cardiology Department, Detroit Medical Center, Detroit, MichiganAbhishek Deshmukh - Cardiology Department, Mayo Clinic, Rochester, MinnesotaApurva Badheka - Cardiology Department, The Everett Clinic, Everett, WashingtonUmesh Gidwani - Cardiology Department, Icahn School of Medicine at Mount Sinai, New York, New YorkRadha Gopalan - Cardiology Department, Icahn School of Medicine at Mount Sinai, New York, New York
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.119(5), pp.760-769
- DOI
- 10.1016/j.amjcard.2016.11.022
- PMID
- 28109560
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 03/01/2017
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094547602771
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