The Impact of Discharged Loop Diuretic Dose to Home Dose on Hospital Readmissions in Patients with Acute Decompensated Heart Failure: A Retrospective Cohort Study

Abstract

<jats:p>Background: Acute decompensated heart failure (ADHF) is associated with a high rate of hospital readmission. The aim of this study is to examine the effect of the discharge diuretic dose compared with the home diuretic dose on hospital readmission in patients with ADHF. Methods: A single center retrospective cohort study included patients with a confirmed diagnosis of ADHF with an ejection fraction of less than 40%. The sample was divided in two groups. The first group received a total daily discharge diuretic dose that was greater than the home dose; the second group received a daily discharge diuretic that was equal to or less than the home dose. The primary outcome was all-cause 30-day readmission rate. The secondary outcomes were all-cause 60-day and 90-day readmission rates. Results: A total of 206 patients met inclusion criteria; 117 patients received a higher loop diuretic dose at discharge, while 89 were discharged with a loop diuretic that was equal to or less than the home dose. Patients in the increased-dose group had an all-cause 30-day readmission rate of 20.5% compared with 37.1% of patients with equal or reduced-dose group; P = .007. Additionally, there were lower readmission rates in 60 and 90 days between the increased and equal or reduced groups (33.3% versus 52.8%, P &lt; .017, and 41.0% versus 62.9%, P &lt; .003, respectively. Conclusions: Among patients admitted to hospital with ADHF and reduced ejection fraction, a discharge loop diuretic dose higher than the home dose was associated with decreased all-cause 30-day, 60-day, and 90-day readmission rates.</jats:p>

Effect of sacubitril/valsartan on hospital readmissions in heart failure with reduced ejection fraction in Saudi Arabia: A multicenter retrospective cohort study

“…The findings of our study are quite interesting since the reported rate of hospital readmission in patients with a history of HFrEF in KSA can be as high as 37%. [ 36 ] Little is known about the effectiveness of sacubitril/valsartan in KSA, and the results of our study could have a meaningful impact on the current practice in Saudi Arabia.…”

An inpatient multidisciplinary educational approach to reduce 30-day heart failure readmissions

“…Despite dramatic improvements in treatment outcomes, hospital readmissions related to exacerbation of HF remain high in many countries. The evidence revealed that all-cause 30-day readmissions due to HF exacerbation in Saudi Arabia can be as high as 37% ( Alshibani et al, 2020a , Alshibani et al, 2020b ). In 2012, the national all-cause 30-day readmission rate after HF admission in the U.S. and Canada was more than 20% ( Measure update and specifications, 2014 , Canadian Institute for Health Information.…”