Author + information
- Marat Fudim,
- Andrew Ambrosy,
- Allison Dunning,
- Randall Starling,
- Justin Ezekowitz,
- Paul Armstrong,
- Marco Metra,
- Adriaan Voors,
- Christopher O'Connor,
- Adrian Hernandez,
- G. Michael Felker and
- Robert Mentz
Background: Patients hospitalized for heart failure (HF) are at high risk for early readmission. Reducing readmissions requires understanding of timing and risk factors for readmission.
Methods: We examined the timing and cause of readmission in ASCEND-HF. We defined 0-7 days as early and 8-30 as late readmission. We conducted a generalized logistic regression analysis with no readmission as the reference group to identify independent predictors of early versus late readmissions.
Results: Total of 6,584 patients were discharged alive by day 30 after randomization. Participants were 65+14 years, 66% were male and the ejection fraction was 30+12.8%. Within 30 days after discharge HF-related readmissions occurred in 345 cases (45.9%) and readmission for other cardiovascular events (CV) occurred in 16% of cases, and 40% of readmissions were non-CV (Figure). Baseline predictors of early all-cause readmission included a history of chronic respiratory disease (OR 1.58, CI 1.16-2.15; p<0.004) and prior HF hospitalization (OR 1.62, CI 1.22-2.16; p=0.001). Late readmission was associated with baseline cerebrovascular disease (OR 1.36, CI 1.09-1.7; p=0.006), chronic loop diuretic use (OR 1.65, CI 1.36-20.5; p<0.0001), and doubling of blood urea nitrogen (OR 1.21, CI 1.09-1.34; p=0.0005).
Conclusions: Large portion of readmissions (40%) are due to non-CV causes and majority of readmissions occurred in the first 15 days. Clinical characteristics at admission predict the risk of early and late readmission
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-258
- 2017 American College of Cardiology Foundation