Abstract 15225: Congestive Heart Failure: Predictors of Readmission and Short-Term Mortality - A National Perspective
Background: Congestive heart failure (CHF) is the most common discharge diagnosis across the US and these patients are particularly vulnerable to readmission and mortality, which increases attention to potential way to address these adverse outcomes.
Methods: The study cohort was derived from the HCUP’s National Readmission Data (NRD) 2013, sponsored by the Agency for Healthcare Research and Quality (AHRQ). CHF was identified by using appropriate ICD 9 CM code as primary diagnosis. The co-primary outcomes were 30-day readmissions and short term mortality (In hospital mortality+30-day mortality). Hierarchical two level logistic models were used to evaluate study outcomes.
Results: In total 301,892 (weighted n= 688,407) principle admissions were included. 55,857 pts (weighted n=126,866) were readmitted within 30 days during the study year. Significant predictors of increase in 30-day readmission included diabetes, chronic lung disease, renal failure, anemia or coagulation defect, discharged to facilities, higher CCI score, lengthier hospital stay, and blood transfusion. While obesity, higher Socioeconomic status, elective admission were predictors of lower 30-day readmission (fig. 1). Significant predictors of higher short term mortality were higher age group, higher charlson score, renal failure and LOS>8 days during index admission. while obesity, female and private payer were negative predictors short term mortality. Blood transfusion during index hospitalization associated with decrease in hospital mortality but does not affect readmission mortality.
Conclusion: Readmission after a hospitalization for CHF is common. Although it may be necessary to readmit some patients, the striking rate of readmission demands efforts to further clarify the determinants of readmission and short term mortality to develop strategies in terms of quality of care and care transitions to prevent this adverse outcome.
Author Disclosures: N. Patel: None. S. Arora: None. S. Lahewala: None. H. Shah: None. P. Patel: None. C. Bambhroliya: None. K. Dhaduk: None. V. Patel: None. E. Aneja: None. S. Patel: None. S. Panaich: None. A. Badheka: None.
- © 2016 by American Heart Association, Inc.