Kwok, CS ORCID: https://orcid.org/0000-0001-7047-1586, Seferovic, PM, Van Spall, HGC, Helliwell, T, Clarson, L, Lawson, C, Kontopantelis, E, Patwala, A, Duckett, S, Fung, E, Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028 and Mamas, MA ORCID: https://orcid.org/0000-0001-9241-8890 (2019) Early Unplanned Readmissions after Admission to Hospital with Heart Failure. American Journal of Cardiology.

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Abstract

Hospital readmissions remain a continued challenge in the care of patients with heart failure (HF). This study aims to examine the rates, temporal trends, predictors and causes of 30-day unplanned readmissions after admission with HF. Patients hospitalized with a primary or secondary diagnosis of HF in the U.S. Nationwide Readmission Database were included. We examined the incidence, trends, predictors and causes of unplanned all-cause readmissions at 30-days. A total of 3,264,082 and 8,724,846 patients were included in the analyses for primary and secondary diagnoses of HF, respectively. The 30-day unplanned readmission rate was 15.1% for primary HF and 14.6% for secondary HF. Predictors of readmission in primary HF included renal failure (OR 1.27 (1.25-1.28)), cancer (OR 1.26 (1.22-1.29)), receipt of circulatory support (OR 2.81 (1.64-4.81)) and discharge against medical advice (OR 2.29 (2.20-2.39)). In secondary HF, the major predictors were receipt of circulatory support (OR 1.43 (1.12-1.84)) and discharge against medical advice (OR 2.01 95%CI (1.95-2.07)). In primary HF 52.4% of patients were readmitted for a non-cardiac cause while for secondary HF 73.9% were readmitted for a non-cardiac cause. For secondary HF, the strongest predictor of readmission was discharge against medical advice (OR 2.06 95%CI 2.01-2.12, p<0.001). Early unplanned readmissions are common among patients hospitalized with HF, and a majority of readmissions are due to causes other than HF. Our results highlight the need to better manage comorbidities in patients with HF.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.amjcard.2019.05.053 - please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 28 May 2019 08:38
Last Modified: 11 Jun 2019 15:28
URI: http://eprints.keele.ac.uk/id/eprint/6399

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