Readmission after hospitalization for heart failure among patients with chronic kidney disease: a prediction model

Perkins, Robert M.; Rahman, A. H. M. Mahbubur; Bucaloiu, Ion D.; Norfolk, Evan; DiFilippo, William; Hartle, James E.; Kirchner, H. Lester

doi:10.5414/cn107961

Cited by 18 publications

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“…Hospital readmission rates at 30 days were reported in studies from the USA, Australia, and China (Extended data: Supplemental Table 6 84 ). In the USA, HF-related rates of readmission were 6.4-12.5% 88,114,115,123,126,127 , and all-cause rates were 17.1-30.4% 80,[88][89][90]102,108,[113][114][115]123,[126][127][128][129][130][131][132] . An additional US study reported all-cause 30-day readmission rates after hospital discharge following implantation of an LVAD as 27.6% 133 .…”

Section: Hospitalization and Readmission Rates For Patients With Hfmentioning

confidence: 99%

Humanistic burden and economic impact of heart failure – a systematic review of the literature

et al. 2019

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Background: Heart failure (HF) is increasing in prevalence worldwide. This systematic review was conducted to inform understanding of its humanistic and economic burden. Methods: Electronic databases (Embase, MEDLINE®, and Cochrane Library) were searched in May 2017. Data were extracted from studies reporting health-related quality of life (HRQoL) in 200 patients or more (published 2007–2017), or costs and resource use in 100 patients or more (published 2012–2017). Relevant HRQoL studies were those that used the 12- or 36-item Short-Form Health Surveys, EuroQol Group 5-dimensions measure of health status, Minnesota Living with Heart Failure Questionnaire or Kansas City Cardiomyopathy Questionnaire. Results: In total, 124 studies were identified: 54 for HRQoL and 71 for costs and resource use (Europe: 25/15; North America: 24/50; rest of world/multinational: 5/6). Overall, individuals with HF reported worse HRQoL than the general population and patients with other chronic diseases. Some evidence identified supports a correlation between increasing disease severity and worse HRQoL. Patients with HF incurred higher costs and resource use than the general population and patients with other chronic conditions. Inpatient care and hospitalizations were identified as major cost drivers in HF. Conclusions: Our findings indicate that patients with HF experience worse HRQoL and incur higher costs than individuals without HF or patients with other chronic diseases. Early treatment of HF and careful disease management to slow progression and to limit the requirement for hospital admission are likely to reduce both the humanistic burden and economic impact of HF.

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Section: Hospitalization and Readmission Rates For Patients With Hfmentioning

confidence: 99%

Humanistic burden and economic impact of heart failure – a systematic review of the literature

et al. 2019

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“…This may not be sufficient as there are many adverse events that can occur between nephrologist appointments. Volume status can fluctuate, due to dietary indiscretions or changes in medication, and can result in hospitalization [ 36 ]. A busy outpatient office does not lend itself to the ongoing patient education required to facilitate dialysis modality choice.…”

Section: Barriers To Optimal Care In Late-stage Ckdmentioning

confidence: 99%

Challenges and opportunities in late-stage chronic kidney disease

Fishbane

Hazzan

Halinski

et al. 2014

Clinical Kidney Journal

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There is increasing recognition that chronic diseases are a major challenge for health delivery systems and treasuries. These are highly prevalent and costly diseases and frequency is expected to increase greatly as the population of many countries ages. Chronic kidney disease (CKD) has not received the same attention as other chronic diseases such as congestive heart failure; yet, the prevalence and costs of CKD are substantial. Greater recognition and support for CKD may require that the disease no longer be viewed as one continuous disease state. Early CKD stages require less complex care and generate lower costs. In contrast, late-stage CKD is every bit as complex and costly as other major chronic diseases. Health authorities may not recognize and fund CKD care appropriately until late-stage CKD is defined clearly as separate and distinct from earlier stages of disease. In this review, we describe the burden of chronic diseases, consider the challenges and barriers and propose processes to improve late-stage CKD care. In particular, we recommend the need for improved continuity of care, enhanced use of information technology, multidisciplinary care, timely referral to nephrologists, protocol use and improved patient engagement.

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“…Comparatively little is known about readmission of dialysis patients following a CVD hospitalization 7, 8. Given the burden of CVD in the dialysis population and the importance of reducing readmission rates, we designed a study to examine readmission rates for dialysis patients admitted for a CVD indication.…”

Section: Introductionmentioning

confidence: 99%

“…5 Comparatively little is known about readmission of dialysis patients following a CVD hospitalization. 7,8 Given the burden of CVD in the dialysis population and the importance of reducing readmission rates, we designed a study to examine readmission rates for dialysis patients admitted for a CVD indication. Using Medicare data, we identified hospitalizations with a primary diagnosis code for CVD and followed the patients with live discharge for the ensuing 30 days to determine rates of all-cause readmission, readmission for a CVD indication, and death.…”

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confidence: 99%

Readmissions Following a Hospitalization for Cardiovascular Events in Dialysis Patients: A Retrospective Cohort Study

Wetmore

Molony

Liu

et al. 2018

JAHA

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BackgroundHospitalization for cardiovascular disease (CVD) is common among patients receiving maintenance dialysis, but patterns of readmissions following cardiovascular events are underexplored.Methods and ResultsIn this retrospective analysis of prevalent, Medicare‐eligible patients receiving dialysis in 2012–2013, all live‐discharge hospitalizations attributed to CVD were ascertained. Rates of all‐cause, CVD‐related, and non–CVD‐related readmissions and death in the ensuing 10 and 30 days were calculated. Multinomial logistic modeling was used to assess the relationship between potential explanatory factors and outcomes of interest. Among 142 210 analyzed hospitalizations, mean age at time of index CVD hospitalization was 64.9±14.1 years; 50.4% of index hospitalizations were for women, and 41.4% were for white patients. Fully 15.6% and 34.2% of CVD hospitalizations resulted in readmission within 10 and 30 days, respectively; less than half of readmissions were CVD related (42.5%, 10 days; 43.1%, 30 days). Death within 30 days, regardless of readmission, occurred after 4.5% of index hospitalizations; 51.2% were attributed to CVD. Compared with ages 65 to 69 years, younger age tended to be associated with increased readmission risk (adjusted relative risk for ages 18–44 years: 1.55; 95% confidence interval, 1.48–1.63). Readmission risk did not differ between white and black patients, but risk of death without readmission was markedly lower for black patients (relative risk: 0.60; 95% confidence interval, 0.55–0.67).ConclusionsRoughly 1 in 3 CVD hospitalizations resulted in 30‐day readmission; nearly 1 in 20 was followed by death within 30 days. Risk of death without readmission was higher for white than black patients, despite no difference in risk of readmission.

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Readmission after hospitalization for heart failure among patients with chronic kidney disease: a prediction model

Abstract: A robust electronic health record may facilitate the identification of CKD patients at risk for readmission after hospitalization for HF.

Cited by 18 publications

References 0 publications

Humanistic burden and economic impact of heart failure – a systematic review of the literature

Humanistic burden and economic impact of heart failure – a systematic review of the literature

Challenges and opportunities in late-stage chronic kidney disease

Readmissions Following a Hospitalization for Cardiovascular Events in Dialysis Patients: A Retrospective Cohort Study

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