Abstract 16425: Determinants of Days Alive and Out of Hospital in Heart Failure
Background: 30-day readmission or death has recently emerged as a major focus in clinical practice and research in heart failure (HF). However, whether this outcome is the most appropriate measure to use remains a debate. This study aimed to compare predictors of 30-day readmission or death with those of an alternative outcome in HF, days alive and out of hospital (DAOH) within 12 months of discharge, which incorporates mortality and all hospitalizations into a single measure.
Methods: Data were from 382 HF patients (61% male, median age 75 years) from the MARATHON study (Australia). Besides standard clinical and administrative data, we collected data on individual socio-demographic and socio-economic status, mental health (PHQ-9 and GAD-7 score), cognitive function (MoCA score), and 2D echocardiograms. Our previously published risk score of 30-day readmission or death (C-statistic=0.82) was used for comparison.
Results: Median DAOH within 12 months was 350 days (IQR 302, 363). The final predictive model of DAOH included NYHA classification (r=–0.29, p<0.001), LV volume index (r=–0.27, p<0.001), LA volume index (r=–0.26, p<0.001), presence of chronic kidney disease (r=–0.22, p=0.007), MoCA score (r=0.21, p<0.001) and presence of life threatening arrhythmia (r=–0.16, p=0.002). Although sharing some common predictors, this model included only clinical factors and were more predictive of DAOH than the risk score of 30-day readmission or death which included both non-clinical and clinical factors (Figure 1).
Conclusions: DAOH provides a valuable tool to estimate the longevity and quality of life in HF patients, and is a different outcome measure from 30-day readmission or death.
Author Disclosures: Q.L. Huynh: None. K. Negishi: None. C.G. De Pasquale: None. J.L. Hare: None. D. Leung: None. T. Stanton: None. T. Marwick: None.
- © 2016 by American Heart Association, Inc.