Abstract 9871: Utility of Electronic Health Records in Predicting 30-Day Readmission After Heart Failure Hospitalization
Introduction: Hospitalizations for heart failure (HF) represent a growing healthcare burden and are a major focus for quality improvement and payment reform. Prior studies have evaluated predictors of readmission after hospitalization for HF, but few have examined consecutive patients at a single medical center using electronic health records (EHRs).
Objectives: (1) Determine predictors of 30 day readmission in patients with a HF discharge diagnosis and (2) evaluate relationship between 30 day readmission and 1 year mortality using the Social Security Death Index.
Methods: We analyzed outcomes of 1,417 consecutive patients with a primary discharge diagnosis of HF for years 2008 and 2009 in an urban, tertiary-care hospital using a unique EHR system integrating inpatient and outpatient data. Outcomes included 30 day all-cause hospital readmissions and all-cause mortality from 30 days to 1 year.
Results: The 30-day readmission rate was 24.8%. Factors associated with readmission included weight, BNP, creatinine, and BUN at both admission and discharge, as well as systolic blood pressure and ejection fraction (Table). Readmitted patients had higher BNP, creatinine, and BUN at the time of discharge compared to corresponding admission data in patients not readmitted (p <0.01). Age, gender, and length of stay (7.3±7.5 vs 7.3±7.6 days, respectively) did not differ between the 2 groups. Readmitted patients were less likely to have hypertension, but other comorbidities did not differ between the 2 groups. Readmission within 30 days was not associated with all-cause mortality at 30, 60, 90, 180 days or 1-year post-discharge.
Conclusion: Patients with HF at risk for 30 day readmission are readily identified by EHR data during the index hospitalization. Real time utilization of EHRs provides potential to detect patients who may benefit most from targeted interventions at discharge to reduce rehospitalization. Short-term readmissions are not related to long-term mortality.
- © 2011 by American Heart Association, Inc.