Abstract 15157: Health Outcomes Among US Managed Care Enrollees Hospitalized With Acute Heart Failure: Variations Based on Age and Comorbid Atrial Fibrillation
Background: This study examined inpatient (IP) length of stay (LOS), readmission and mortality by age and comorbid atrial fibrillation (AF) among individuals hospitalized with acute heart failure (AHF).
Methods: A retrospective administrative claims-based study using medical, pharmacy and enrollment data from a large US health plan (Jan2007-Sep2012) was conducted. Subjects were ≥18 y, had 12 months and up to 6 months continuous enrollment pre- and post- index IP stay for AHF, and no AHF IP stay in the prior year. Chi-square, one-way ANOVA and log-rank tests were used to examine differences in study variables across age group and evidence of AF.
Results: 172,713 AHF patients (mean age 72 y, 51% female, 60% Medicare Advantage, 75% white, 26% with AF) were included. Mean index IP LOS differed across age groups (18-44, 45-64, 65-74, ≥75; p<0.001); with a difference of 5 days between very elderly (≥75 y) and younger (18-74 y) patients. HF-related 6-month readmission probability differed across age groups (p<0.001); 24% in elderly and 28% in very elderly. All-cause 6-month mortality probability also differed across age groups (p<0.001, Figure 1). Mean index IP LOS did not differ meaningfully based on evidence of AF. HF-related 6-month readmission probability differed by evidence of AF (p<0.001); 31% with AF and 23% without AF. All-cause 6-month mortality probability also differed by evidence of AF (p<0.001); 15% with AF and 12% without AF.
Conclusion: Study results suggest that outcomes following HF hospital admission vary substantially by age and comorbid AF. These patient factors can be used to inform management of AHF patients and identify those at highest risk for lengthy stays, future readmissions, and death. The very elderly are at highest risk for hospital readmissions, increased LOS, and mortality.
- © 2013 by American Heart Association, Inc.