Keele Research Repository
Explore the Repository
Kwok, CS, Seferovic, PM, Van Spall, HGC, Helliwell, T, Clarson, L, Lawson, C, Kontopantelis, E, Patwala, A, Duckett, S, Fung, E, Mallen, CD and Mamas, MA (2019) Early Unplanned Readmissions after Admission to Hospital with Heart Failure. American Journal of Cardiology, 124 (5). pp. 736-745. ISSN 1879-1913
![[thumbnail of Kwok-2019-early-unplanned-readmissions-american-journal-cardiology-aam-28052019.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Kwok-2019-early-unplanned-readmissions-american-journal-cardiology-aam-28052019.docx - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (46kB)
![[thumbnail of Supplementary Material.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Supplementary Material.docx - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (1MB)
Figure 1.tif - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (121kB) | Preview
Figure 2.tif - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (152kB) | Preview
![[thumbnail of Table 1.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Table 1.docx - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (15kB)
![[thumbnail of Table 2.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Table 2.docx - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (17kB)
![[thumbnail of Table 3.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Table 3.docx - Supplemental Material
Available under License Creative Commons Attribution Non-commercial No Derivatives.
Download (16kB)
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: | 06 Jun 2020 01:30 |
URI: | https://eprints.keele.ac.uk/id/eprint/6399 |