Abstract 2507: Gender and Ethnicity Confer Greatest Risk for Rehospitalization in Heart Failure Patients
Background: Patients with advanced HF experience frequent hospitalization events. Identification of factors that predict rehospitalization may enable more tailored therapies and improve discharge planning for patients at high risk for rehospitalization.
Objective: To determine whether demographic, clinical or psychological (QOL) variables confer increased risk for rehospitalization in a hospitalized, heart failure (HF) population.
Methods: Patients (n=72) were enrolled and followed for 90 days after discharge. Data collected were: demographic and clinical, with psychological (QOL) and functional (six-minute walk test (6MWT)) variables obtained in the hospital within 48 hours of discharge.
Results: Subjects’ mean age was 61.5 ± 17.9 with almost half (n=32) non-Caucasian and two-thirds (n=47) male gender. Mean New York Heart Association classification was 3.25 ± 0.7, mean discharge brain natriuretic peptide (BNP) level was 824.8ng/L ± 715.9, mean QOL score was 34.1 ± 21.1, and mean 6MWT distance was 186.2 ± 99 meters. Almost half (n=34) were rehospitalized for cardiac reasons within 90 days. Females had a 2.5 times greater risk for rehospitalization than males. Both female gender and non-Caucasian ethnicity incurred at least a 2 times greater risk for cardiac rehospitalization. The median number of days before rehospitalization was: 52 in females, 66 in non-Caucasians, 40 in non-Caucasian females, and >90 days in males. Females walked significantly shorter distances than males. BNP level and 6MWT score did not predict rehospitalization risk.
Conclusions: Gender and non-white ethnicity conferred a greater risk for rehospitalization over physiological and psychological variables. This study is novel because it demonstrates that sociodemographic factors are better predictors of rehospitalization than more traditional markers in patients hospitalized for HF. In the age of limited resources, clinicians need to identify patients at greatest risk for rehospitalization during hospitalization. Evaluation for support services are needed to prevent rehospitalization, especially in females and non-whites.