Abstract 13461: Risks for Heart Failure Readmission within 90 days - A Meta-Analysis of 1,640,014 Subjects
Background: Heart failure (HF) readmissions are a common and serious problem of heterogeneous etiology. A better understanding of the risks for readmission may permit more effective targeting of disease management strategies. We performed a meta-analysis of risk factors for the prediction of HF readmission to identify the highest risk pts.
Methods: Electronic databases were systematically searched for studies reporting risk factors for HF readmission within 90 days of discharge using the following key MeSH terms "heart failure, congestive", “risk", and "patient readmission". The primary outcome was a composite of all-cause death or readmission. Relative risk (RR) of each risk variable was extracted. RR and 95% confidence intervals (CIs) were computed for each risk variable using a random-effects model weighted by inverse variance.
Results: Forty studies (1,640,014 pts) were included and 23 factors were reported more than twice. The significant associations of 90-day readmission were chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), cognitive impairment, atherosclerotic vascular disease (peripheral, coronary, cerebrovascular), diabetes, hyponatremia, and lack of beta-blockade and aldosterone antagonist use (Figure). However, male gender, hypertension, black race, smoking, atrial fibrillation, depression, ACEi/ARB use, diuretics use, and EF<40% were not significant.
Conclusion: Comorbidity, diabetes and failure to use evidence based medication are more strongly associated with short-term HF readmission than standard HF risk factors.
Author Disclosures: M. Saito: None. K. Negishi: None. T.H. Marwick: None.
- © 2014 by American Heart Association, Inc.