Chronic obstructive pulmonary disease (OR 6.4), HIV infection, African-American ethnicity, and other clinical factors were independently associated with an increased risk of early readmission within 60 days in patients with acutely decompensated heart failure.
Cohort (n=685)
No
What clinical factors are associated with early readmission in adult patients admitted for acutely decompensated heart failure?
Several clinical factors, including COPD, HIV, African-American ethnicity, and absence of ACEi/ARB therapy, are independently associated with early readmission in acutely decompensated heart failure patients, which can be used to develop a risk stratification scoring system.
Effect estimate: OR 6.4
p-value: p=<0.0001
INTRODUCTION: Congestive heart failure (CHF) is a common cause of hospital readmission. MATERIAL AND METHODS: A retrospective study was conducted at Harlem Hospital in New York City. Data were collected for 685 consecutive adult patients admitted for decompensated CHF from March, 2009 to December, 2012. Variables including patient demographics, comorbidities, laboratory studies, and medical therapy were compared between CHF patient admissions resulting in early CHF readmission and not resulting in early CHF readmission. RESULTS: Clinical factors found to be independently significant for early CHF readmission included chronic obstructive pulmonary disease (odds ratio (OR) = 6.4), HIV infection (OR = 3.4), African-American ethnicity (OR = 2.2), systolic heart failure (OR = 1.9), atrial fibrillation (OR = 2.3), renal disease with glomerular filtration rate < 30 ml/min (OR = 2.7), evidence of substance abuse (OR = 1.7), and absence of angiotensin-converting enzyme inhibitors or angiotensin receptor blocker therapy after discharge (OR = 1.8). The ORs were used to develop a scoring system regarding the risk for early readmission. CONCLUSIONS: Identifying patients with clinical factors associated with early CHF readmission after an index hospitalization for CHF using the proposed scoring system would allow for an early CHF readmission risk stratification protocol to target particularly high-risk patients.
Pierre-Louis et al. (Fri,) conducted a cohort in Acutely decompensated heart failure (n=685). Chronic obstructive pulmonary disease (COPD) vs. Absence of COPD was evaluated on Early CHF readmission (< 60 days) (OR 6.4, p=<0.0001). Chronic obstructive pulmonary disease (OR 6.4), HIV infection, African-American ethnicity, and other clinical factors were independently associated with an increased risk of early readmission within 60 days in patients with acutely decompensated heart failure.