Abstract 15290: Predictors of 30-Day Readmission and In-Hospital Mortality of Patients With Heart Failure With Preserved Ejection Fraction: A National Population-Based Cohort Study
Background: Rising prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) and limited data on outcomes such as 30 day readmissions and short term mortality is concerning.
Methods: We utilized the National Readmission Data (NRD) 2013, subset of the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality (AHRQ). HFpEF was identified using ICD 9 code (428.3x) as primary diagnosis. Co-morbidities identified by “CM_” variables provided by NRD. Charlson Comorbidity Index (CCI) calculated using appropriate ICD 9 codes as secondary diagnosis. Primary outcome was 30 day readmissions and secondary outcomes were in hospital and re-admission mortality. Two level hierarchical logistic model were used to find predictors of outcomes.
Results: Analysis included 95,144 (weighted n=219,419) patients. 19.54% (18,592) patients (weighted n=42,836) were readmitted within 30 days of index hospitalization. Patients with diabetes, chronic pulmonary disease, peripheral vascular disease, renal failure, anemia or coagulation defect, transfusion during principle admission, higher CCI (≥3), discharge to long/short term facility and longer length of stay (LOS) tends to have higher 30 day readmission. Interestingly, patients with obesity, higher age group, higher socioeconomic status, private insurance (as compare to Medicare/Medicaid) less likely to have 30 day readmission. Yet, patients with higher age group, transfusion during index admission, higher CCI and longer LOS(>6 days) were associated with higher in hospital and readmission mortality.
Conclusion: Given, increasingly growing HFpEF patient population, and lack of evidence-based strategies for effective management of HFpEF patient population. We have identified important predictors of 30 day readmissions and short term mortality that would help to understand the population and aid to prevent hospital readmissions and decrease cost of care.
Author Disclosures: S. Setareh-Shenas: None. S. Arora: None. H. Ul Hassan Virk: None. N. Patel: None. B. Tripathi: None. E.F. Aziz: None. U.K. Gidwani: None.
- © 2016 by American Heart Association, Inc.