Abstract 12927: Concurrent Pneumonia has no Association With 30-Day All-Cause or Heart Failure Readmissions but is Associated With Higher 30-Day Pneumonia Readmission and MayBe Associated With Higher 30-Day All-Cause Mortality in Older Medicare Beneficiaries Hospitalized for Heart Failure
Background: Pneumonia (20%) is the second leading cause for 30-day all-cause readmission after heart failure (HF; 27%). However, little is known about the impact of pneumonia during index HF hospitalization on 30-day all-cause readmission.
Methods: Of the 8049 Medicare beneficiaries hospitalized for decompensated HF (72% with known HF) discharged alive from 106 U.S. hospitals (1998-2001), 2048 (25%) had pneumonia (1670 on admission and 378 in-hospital). Using propensity scores for pneumonia, we assembled a matched cohort of 1982 pairs of patients balanced on 33 baseline characteristics.
Results: 30-day all-cause readmissions occurred in 899 (23%) of matched patients and there was no difference between those with and without pneumonia (HR, 1.00; 95% CI, 0.88-1.15; p=0.947; Fig, left). 30-day pneumonia readmission occurred in 41 matched patients which was higher among those with pneumonia (HR, 1.96; 95% CI, 1.03-3.74; p=0.041). 30-day HF readmission occurred in 342 patients but had no association with pneumonia (HR, 1.10; 95% CI, 0.89-1.36; p=0.365). 30-day all-cause death occurred in 303 patients, which was higher among those with pneumonia (9% vs 7%; HR, 1.26; 95% CI, 1.00-1.58; p=0.046; Fig, right). These associations persisted throughout 12 months post-discharge.
Conclusions: Among patients with HF, on-admission or in-hospital pneumonia during index hospital admission is associated with significantly higher 30-day death and pneumonia readmissions but not with 30-day all-cause or HF readmissions
Author Disclosures: C. Inampudi: None. R.D. Fletcher: None. S. Zhang: None. C. Morgan: None. P. Deedwania: None. G.C. Fonarow: Consultant/Advisory Board; Modest; Medtronic, Amgen, Johnson & Johnson, Bayer, Boston Scientific. Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Novartis. W.S. Aronow: None. W. Wu: None. C.J. Brown: None. S.D. Anker: None. R.M. Allman: None. A. Ahmed: None.
- © 2015 by American Heart Association, Inc.