open access

Vol 23, No 2 (2016)
CLINICAL CARDIOLOGY AND HEART FAILURE - Original articles
Published online: 2016-01-07
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Prior hospital admission predicts thirty-day hospital readmission for heart failure patients

Donald P. McLaren, Roy Jones, Ronald Plotnik, Wojciech Zareba, Scott McIntosh, Jeffrey Alexis, Leway Chen, Robert Block, Charles J. Lowenstein, Valentina Kutyifa
DOI: 10.5603/CJ.a2016.0005
·
Pubmed: 26779968
·
Cardiol J 2016;23(2):155-162.

open access

Vol 23, No 2 (2016)
CLINICAL CARDIOLOGY AND HEART FAILURE - Original articles
Published online: 2016-01-07

Abstract

Background: Hospital readmission is a significant health burden. More than 20% of heart failure (HF) patients are readmitted within 30 days of discharge leading to billions of dollars in health care expenditures. However, the role of prior hospital admissions to predict 30-day readmission for HF patients is not fully understood.

Methods: We retrospectively analyzed HF hospitalization data for 4 years at a single medical center. Association between prior admission and 30-day readmission after HF hospitalization was assessed using a multivariate logistic regression model.

Results: A total of 1,999 patients with index HF hospitalizations were identified, and 366 of them (18%) were readmitted within 30 days. The rate of readmission was 14%, 20%, and 33% in patients with 0, 1, ≥ 2 prior admissions. Patients with one prior admission had a 50% higher risk (confidence interval [CI] 1.10–2.05, p = 0.011) for readmission, while those with ≥ 2 prior admissions had a more than 3-fold increase in readmission (CI 2.27–4.09, p < 0.001), after adjustments for relevant clinical covariates. Prior hospital admission provided incremen­tal value in predicting readmissions, shown by the significant improvement in the readmission predictive model (C-statistics increased from 0.57 to 0.63). However, neither the length of stay nor recency of prior admission was a significant factor in predicting readmissions.

Conclusions: Hospital admission prior to an index HF hospitalization is associated with a significantly increased risk for 30-day hospital readmission and could be used to identify patients at high-risk for readmission and potentially target interventions to reduce the risk of readmission for these patients

Abstract

Background: Hospital readmission is a significant health burden. More than 20% of heart failure (HF) patients are readmitted within 30 days of discharge leading to billions of dollars in health care expenditures. However, the role of prior hospital admissions to predict 30-day readmission for HF patients is not fully understood.

Methods: We retrospectively analyzed HF hospitalization data for 4 years at a single medical center. Association between prior admission and 30-day readmission after HF hospitalization was assessed using a multivariate logistic regression model.

Results: A total of 1,999 patients with index HF hospitalizations were identified, and 366 of them (18%) were readmitted within 30 days. The rate of readmission was 14%, 20%, and 33% in patients with 0, 1, ≥ 2 prior admissions. Patients with one prior admission had a 50% higher risk (confidence interval [CI] 1.10–2.05, p = 0.011) for readmission, while those with ≥ 2 prior admissions had a more than 3-fold increase in readmission (CI 2.27–4.09, p < 0.001), after adjustments for relevant clinical covariates. Prior hospital admission provided incremen­tal value in predicting readmissions, shown by the significant improvement in the readmission predictive model (C-statistics increased from 0.57 to 0.63). However, neither the length of stay nor recency of prior admission was a significant factor in predicting readmissions.

Conclusions: Hospital admission prior to an index HF hospitalization is associated with a significantly increased risk for 30-day hospital readmission and could be used to identify patients at high-risk for readmission and potentially target interventions to reduce the risk of readmission for these patients

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Keywords

heart failure, readmissions, prior admissions, predictive model

About this article
Title

Prior hospital admission predicts thirty-day hospital readmission for heart failure patients

Journal

Cardiology Journal

Issue

Vol 23, No 2 (2016)

Pages

155-162

Published online

2016-01-07

DOI

10.5603/CJ.a2016.0005

Pubmed

26779968

Bibliographic record

Cardiol J 2016;23(2):155-162.

Keywords

heart failure
readmissions
prior admissions
predictive model

Authors

Donald P. McLaren
Roy Jones
Ronald Plotnik
Wojciech Zareba
Scott McIntosh
Jeffrey Alexis
Leway Chen
Robert Block
Charles J. Lowenstein
Valentina Kutyifa

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