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Prior hospital admission predicts thirty-day hospital readmission for heart failure patients.
Cardiol J. 2016 Jan 18;
Authors: McLaren DP, Jones R, Plotnik R, Zareba W, McIntosh S, Alexis J, Chen L, Block R, Lowenstein C, Kutyifa V
Abstract
BACKGROUND: Hospital readmission is a significant health burden. More than 20% of heart failure (HF) patients are readmitted within 30 days of discharge leading to billions of dollars in health care expenditures. However, the role of prior hospital admissions to predict 30-day readmission for heart failure (HF) patients is not fully understood.
METHODS: We retrospectively analyzed HF hospitalization data for 4 years at a single medical center. Association between prior admission and 30-day readmission after HF hospitalization was assessed using multivariate logistic regression model.
RESULTS: A total of 1999 patients with index HF hospitalizations were identified, and 366 of them (18%) were readmitted within 30 days. The rate of readmission was 14%, 20%, and 33% in patients with 0, 1, ≥2 prior admissions. Patients with one prior admission had a 50% higher risk (CI: 1.10-2.05, p=0.011) for readmission, while those with ≥2 prior admission had a more than 3-fold increase in readmission (CI: 2.27-4.09, p<0.001), after adjustments for relevant clinical covariates. Prior hospital admission provided incremental value in predicting readmissions, shown by the significant improvement in the readmission predictive model (C-statistics increased from 0.57 to 0.63). However, neither the length of stay nor recency of prior admission was a significant factor in predicting readmissions.
CONCLUSIONS: Hospital admission prior to an index heart failure hospitalization is associated with a significantly increased risk for 30-day hospital readmission and could be used to identify patients at high-risk for readmission and potentially target interventions to reduce the risk of readmission for these patients.
PMID: 26779968 [PubMed - as supplied by publisher]