Key result
Depressed left ventricular ejection fraction (≤40%) in hospitalized heart failure patients was associated with increased odds of readmission for any cause (OR 2.07; 95% CI 1.15-3.78).
Why the study?
Does depressed left ventricular ejection fraction (≤ 40%) increase short-term adverse outcomes and resource utilization in patients hospitalized for heart failure?
Observational (n=443)
Does depressed left ventricular ejection fraction (≤ 40%) increase short-term adverse outcomes and resource utilization in patients hospitalized for heart failure?
Effect estimate: OR 2.07 (95% CI 1.15-3.78)
Absolute Event Rate: 0.4% vs 0.3%
p-value: p=0.05
Depressed LVEF (≤ 40%) in patients hospitalized for heart failure is associated with increased short-term resource utilization and higher 30-day readmission rates.
Should not yet guide readmission prevention strategies; leaves open whether LVEF-targeted interventions improve short-term HF outcomes.
BACKGROUND: While depressed left ventricular ejection fraction is clearly associated with poor long-term outcome in heart failure (HF), the effect of ejection fraction on short-term outcomes and resource utilization following hospitalization for HF remains unclear. HYPOTHESIS: We evaluated the independent effect of depressed ejection fraction (< or = 40%) on short-term outcomes and resource utilization following hospitalization for HF. METHODS: The study population included 443 consecutive patients hospitalized for DRG 127 (HF and shock) with known ejection fraction. For each patient, we assessed the hospitalization cost (1995 US$), length of stay, in-hospital mortality, 30-day mortality, and 30-day readmission rates. RESULTS: Despite similar disease severity at admission, patients with ejection fraction < or = 40% (Group 1) had longer length of stay (4.0 vs. 3.7 days; p = 0.03), a tendency toward higher hospitalization cost ($3,054 vs. $2,770; p = 0.08), more readmissions for any cause (0.4 vs. 0.3; p = 0.05) and for HF (0.2 vs. 0.1; p = 0.01), but similar in-hospital (2.5 vs. 2.6%) and 30-day mortality (4.0 vs. 4.6%) compared with patients with ejection fraction > 40% (Group 2). In multivariate analyses, Group 1 patients were more likely to have higher than median hospitalization cost [odds ratio (OR) = 1.98; 95% confidence intervals (CI) = 1.02-3.91] and longer than median hospital stay (OR = 1.68; CI = 1.08-3.91); they were also more likely to be readmitted for any cause (OR = 2.07; CI = 1.15-3.78) or for HF (OR = 5.71; CI = 1.64-21.94), and they tended to have a higher 30-day incidence of death or readmission (OR = 1.65; CI = 0.96-2.84). CONCLUSIONS: Depressed left ventricular ejection fraction is associated with higher resource utilization and readmission rates following hospitalization for HF. Greater focus on patients with depressed ejection fraction may increase cost savings from HF disease management programs.
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Harjai et al. (1999) conducted an observational in Heart failure (n=443). Depressed ejection fraction (≤ 40%) vs. Ejection fraction > 40% was evaluated on Readmission for any cause (OR 2.07, 95% CI 1.15-3.78, p=0.05). Depressed left ventricular ejection fraction (≤40%) in hospitalized heart failure patients was associated with increased odds of readmission for any cause (OR 2.07; 95% CI 1.15-3.78).
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