The Utility of Nursing Notes Among Medicare Patients With Heart Failure to Predict 30-Day Rehospitalization: A Pilot Study

Link to article at PubMed

J Cardiovasc Nurs. 2021 Dec 21. doi: 10.1097/JCN.0000000000000871. Online ahead of print.


BACKGROUND: For patients with heart failure (HF), there have been efforts to reduce the risk of 30-day rehospitalization, such as developing predictive models using electronic health records. Few previous studies used clinical notes to predict 30-day rehospitalization.

OBJECTIVE: The aim of this study was to assess the utility of nursing notes versus discharge summaries to predict 30-day rehospitalization among patients with HF.

METHODS: In this pilot study, we used free-text discharge summaries and nursing notes collected from a tertiary hospital. We randomly selected 500 Medicare patients with HF. We followed the natural language processing and machine learning pipeline for data analysis.

RESULTS: Thirty-day rehospitalization risk prediction using discharge summaries (n = 500) produced an area under the receiver operating characteristic curve of 0.74 (Bag of Words + Neural Network). Thirty-day rehospitalization risk prediction using nursing notes (n = 2046) resulted in an area under the receiver operating characteristic curve of 0.85 (Bag of Words + Neural Network).

CONCLUSION: Nursing notes provide a superior input to risk models for 30-day rehospitalization in Medicare patients with HF compared with discharge summaries.

PMID:34935742 | DOI:10.1097/JCN.0000000000000871

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