Patient Characteristics Predicting Readmission Among Individuals Hospitalized for Heart Failure

Abstract

Heart failure is difficult to manage and increasingly common with many individuals experiencing frequent hospitalizations. Little is known about patient factors consistently associated with hospital readmission. A literature review was conducted to identify heart failure patient characteristics, measured before discharge, that contribute to variation in hospital readmission rates. Database searches yielded 950 potential articles, of which 34 studies met inclusion criteria. Patient characteristics generally have a very modest effect on all-cause or heart failure–related readmission within 7 to 180 days of index hospital discharge. A range of cardiac diseases and other comorbidities only minimally increase readmission rates. No single patient characteristic stands out as a key contributor across multiple studies underscoring the challenge of developing successful interventions to reduce readmissions. Interventions may need to be general in design with the specific intervention depending on each patient's unique clinical profile.

Inpatient palliative care referral and 9‐month hospital readmission in patients with congestive heart failure: a linked nationwide analysis

“…In our study, other factors associated with lower 9‐month readmission rates included lack of insurance coverage, DNR status and discharge home (compared to discharge to hospice or to a skilled nursing facility). Previous work has identified, amongst other factors, nonwhite race, prior hospitalizations, increased length of stay and co‐morbid cardiac or systemic disease, and HF severity as factors associated with higher readmission rates . Notably in the present study, the influence of PC on readmission remained significant whilst controlling for many of these factors, suggesting a robust role for inpatient PC in reducing readmission in HF.…”

Differences in nutritional status and activities of daily living and mobility in elderly hospitalized patients with heart failure

“…A previous study showed a relationship between nutritional status and severity in HF. 28 In the present study, it appeared that nutritional status did not reflect severity because it was possible that owing to inclusion criteria that we chose, not so many cases of severe HF were included. It was reported that ADL and NYHA in HF patients were correlated.…”

“…27 There is a relation between cardiovascular disease history and the severity of risk factors in HF. 28 In the present study, it appeared that nutritional status did not reflect severity because it was possible that owing to inclusion criteria that we chose, not so many cases of severe HF were included.…”

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow‐Up

“…Indicators of need/illness level tend to have the greatest impact on health care use in empirical work (O'Connor et al. ). In our study, unmeasured aspects of patient acuity (e.g., cardiac ejection fraction) are probable confounders because, consistent with the Andersen model, they contribute to more severely ill patients being more likely to receive the treatments and to be readmitted to a hospital.…”