Trends, causes and timing of 30-day readmissions after hospitalization for heart failure: 11-year population-based analysis with linked data

Fernández-Gassó, Lucía; Hernando-Arizaleta, Lauro; Palomar-Rodríguez, Joaquín A.; Abellán-Pérez, María Victoria; Pascual-Figal, Domingo A.

doi:10.1016/j.ijcard.2017.07.094

Cited by 39 publications

(23 citation statements)

References 26 publications

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“…Interestingly, age did not represent a risk factor for early readmission also in a surgical cohort with only 14.9% of the patients older than 65 years 13. However, it is worth noting that the overall prevalence of early readmissions was small (8.2%) and a large number of readmissions were mainly due to confounding issues of substance abuse or homelessness 10. Although the substantially shorter (5 days) median length of hospital-stay of our cohort, it resulted in significantly longer in both IA and PPR than in SA patients (p<0.05), suggesting that the reduction of the length of hospital stay may reduce, rather than increase, the risk of PPR.…”

Section: Discussionmentioning

confidence: 80%

<p>30-Day Potentially Preventable Hospital Readmissions In Older Patients: Clinical Phenotype And Health Care Related Risk Factors</p>

Calsolaro¹,

Antognoli²,

Pasqualetti³

et al. 2019

CIA

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PurposeEarly readmission rate has been regarded as an indicator of in-hospital and post-discharge quality of care. Evaluating the contributing factors is crucial to optimize the healthcare and target the intervention. In this study we evaluated the potential for preventing 30-day hospital readmission in a cohort of older patients and identified possible risk factors for readmission.Patients and methodsDiagnosis-Related Group (DRG) codes of patients consecutively hospitalized for acute disease in the Geriatrics Unit of the University Hospital of Pisa within a 1-year window were recorded. All the patients had received a comprehensive geriatric assessment. Crossing and elaboration of the DRG codes was performed by the Potentially Preventable Readmission Grouping software (3M™ Corporation). DRG codes were classified as stand-alone admissions (SA), index admissions (IA) and potentially preventable readmissions (PPR) within a time window of 30 days after discharge.ResultsIn total, 1263 SA and 171 IA were identified, with an overall PPR rate of 11.9%. Hospitalizations were significantly longer in IA and PPR than SA (p<0.05). The more frequent readmission causes were acute heart failure, pulmonary edema, sepsis, pneumonia and stroke. In acute heart failure a nonlinear U-shaped readmission trend (with nadir at 5 days of hospitalization) was observed while, in all the other DRG codes, the PPR rate increased with increasing length of hospitalization. Comprehensive geriatric assessment showed a significantly lower degree of disability and comorbidity in SA than IA patients. At stepwise regression analysis, a high degree of disability and comorbidity as well as the diagnosis of sepsis emerged as independent risk factors for PPR.ConclusionAddressing PPR is crucial, especially in older patients. The adequacy of treatment during hospitalization (especially in cases of sepsis) as well as the setting of a comprehensive discharge plan, accounting for comorbidity and disability of the patients, are essential to reduce PPR.

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Section: Discussionmentioning

confidence: 80%

<p>30-Day Potentially Preventable Hospital Readmissions In Older Patients: Clinical Phenotype And Health Care Related Risk Factors</p>

Calsolaro¹,

Antognoli²,

Pasqualetti³

et al. 2019

CIA

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“…19 Of patients discharged from an index HF hospitalization in the US and Canada (2005-2015), the 30-day CVD-related readmission rates were comparable to ours and declined modestly over time. 24 In Spain (2003-2013), 25 however, 30-day CVD-related readmission rates increased over time.…”

Section: In-hospital Mortalitymentioning

confidence: 99%

Heart failure in Norway, 2000–2014: analysing incident, total and readmission rates using data from the Cardiovascular Disease in Norway (CVDNOR) Project

Sulo

Igland

Øverland

et al. 2019

European J of Heart Fail

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Aims To examine trends in heart failure (HF) hospitalization rates and risk of readmissions following an incident HF hospitalization. Methods and results During 2000–2014, we identified in the Cardiovascular Disease in Norway Project 142 109 hospitalizations with HF as primary diagnosis. Trends of incident and total (incident and recurrent) HF hospitalization rates were analysed using negative binomial regression models. Changes over time in 30‐day and 3‐year risk of HF recurrences or cardiovascular disease (CVD)‐related readmissions were analysed using Fine and Grey competing risk regression, with death as competing events. Age‐standardized rates declined on average 1.9% per year in men and 1.8% per year in women for incident HF hospitalizations (both Ptrend < 0.001) but did not change significantly in either men or women for total HF hospitalizations. In men surviving the incident HF hospitalization, 30‐day and 3‐year risk of a HF recurrent event increased 1.7% and 1.2% per year, respectively. Similarly, 30‐day and 3‐year risk of a CVD‐related hospitalization increased 1.5% and 1.0% per year, respectively (all Ptrend < 0.001). No statistically significant changes in the risk of HF recurrences or CVD‐related readmissions were observed among women. In‐hospital mortality for a first and recurrent HF episode declined over time in both men and women. Conclusions Incident HF hospitalization rates declined in Norway during 2000–2014. An increase in the risk of recurrences in the context of reduced in‐hospital mortality following an incident and recurrent HF hospitalization led to flat trends of total HF hospitalization rates.

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“…Heart failure continues to be a primary reason for hospitalization in patients older than 65 years and an issue to health care systems. 4 In addition to the initial admission cases, heart failure remains the leading cause of 30-day hospital readmissions. 4 National data suggests that heart failure readmission rates have steadily increased over the last decade.…”

mentioning

confidence: 99%

Heart Failure with Preserved Ejection Fraction and 30-Day Readmission

et al. 2020

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Trends, causes and timing of 30-day readmissions after hospitalization for heart failure: 11-year population-based analysis with linked data

Cited by 39 publications

References 26 publications

<p>30-Day Potentially Preventable Hospital Readmissions In Older Patients: Clinical Phenotype And Health Care Related Risk Factors</p>

<p>30-Day Potentially Preventable Hospital Readmissions In Older Patients: Clinical Phenotype And Health Care Related Risk Factors</p>

Heart failure in Norway, 2000–2014: analysing incident, total and readmission rates using data from the Cardiovascular Disease in Norway (CVDNOR) Project

Heart Failure with Preserved Ejection Fraction and 30-Day Readmission

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