Abstract 11230: Timing of Readmission Following Heart Failure Hospitalization - Before and After 30 Days
Introduction: Readmission ≤ 30 days of discharge from heart failure (HF) hospitalization is clinically and financially important, but causes and risk factors for readmission ≤ 30 days compared with later readmission are not well known.
Hypothesis: We hypothesized patients in an acute heart failure trial population readmitted early (≤ 30 days , RE) vs. readmitted later (> 30 days, RL) would have particular characteristics and causes for readmission suggesting greater disease severity and less pharmacotherapy.
Methods: From three acute heart failure trials [Diuretic Strategies Optimization Evaluation (DOSE), Cardiorenal Rescue Study in Acute Decompensated Heart Failure (CARRESS), and Renal Optimization Strategies Evaluation (ROSE)], we identified 744 unique patients discharged from index hospitalization with post-discharge follow-up. Patient characteristics (baseline and discharge/Day 7) and readmission causes were compared between RE and RL patients. Causes of readmission were classified as HF, renal, cardiovascular non-HF (CVNHF), and non-cardiovascular/non-renal (NCNR).
Results: All-cause readmission rates were 25% by 30 days and 37% by end of follow-up. Basic demographics and renal function were similar between groups. Compared with RL patients, RE patients had less use of pharmacotherapy, slightly higher heart rate, and higher plasma renin activity at baseline. At discharge/day 7, nitrate and aldosterone antagonist use were less common among RE. See table. CVNHF causes were more common in RE vs. RL patients (23% vs. 10%, p=0.016) while HF (50% vs. 57%, p=0.25), renal (5% vs. 2.3%, p=0.51), and NCNR causes (23% vs. 30%, p=0.19) were not.
Conclusions: Increased neuro-hormonal activation, less pharmacotherapy, and more CVNHF causes for readmission characterize RE vs. RL patients. These characteristics likely represent greater disease severity, yet may be candidates for predicting or preventing early readmission.
Author Disclosures: J.M. Vader: None. S.J. LaRue: None. A. Lala: None. R.J. Mentz: Research Grant; Significant; BMS, AstraZeneca, GSK, Novartis, Gilead, Otsuka. A.D. DeVore: Other Research Support; Modest; American Heart Association, Novartis, Thoratec. J.D. Groarke: None. J. Grodin: None. O.F. Abou Ezzedine: None. S.M. Dunlay: None. V.G. Dávila-Román: None. L. de las Fuentes: None.
- © 2014 by American Heart Association, Inc.