MedStar Authors catalog › Details for: Association of 30-Day All-Cause Readmission with Long-Term Outcomes in Hospitalized Older Medicare Beneficiaries with Heart Failure.
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Association of 30-Day All-Cause Readmission with Long-Term Outcomes in Hospitalized Older Medicare Beneficiaries with Heart Failure.

by Lam, Phillip H.
Citation: American Journal of Medicine. 129(11):1178-1184, 2016 Nov.Journal: The American journal of medicine.Published: 2016ISSN: 0002-9343.Full author list: Arundel C; Lam PH; Khosla R; Blackman MR; Fonarow GC; Morgan C; Zeng Q; Fletcher RD; Butler J; Wu WC; Deedwania P; Love TE; White M; Aronow WS; Anker SD; Allman RM; Ahmed A.UI/PMID: 27401949.Subject(s): Aged | Aged, 80 and over | Alabama/ep [Epidemiology] | Case-Control Studies | Cohort Studies | Comorbidity | Coronary Artery Disease/ep [Epidemiology] | Diabetes Mellitus/ep [Epidemiology] | Female | Follow-Up Studies | Heart Failure/ep [Epidemiology] | *Heart Failure/th [Therapy] | Hospitalization | Humans | Male | Medicare | Middle Aged | *Mortality | Multivariate Analysis | *Patient Readmission/sn [Statistics & Numerical Data] | Prognosis | Propensity Score | Proportional Hazards Models | Pulmonary Disease, Chronic Obstructive/ep [Epidemiology] | Renal Insufficiency, Chronic/ep [Epidemiology] | Treatment Outcome | United StatesInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.amjmed.2016.06.018 (Click here) Abbreviated citation: Am J Med. 129(11):1178-1184, 2016 Nov.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present.Abstract: BACKGROUND: Heart failure is the leading cause for 30-day all-cause readmission. We examined the impact of 30-day all-cause readmission on long-term outcomes and cost in a propensity score-matched study of hospitalized patients with heart failure.Abstract: METHODS: Of the 7578 Medicare beneficiaries discharged with a primary diagnosis of heart failure from 106 Alabama hospitals (1998-2001) and alive at 30 days after discharge, 1519 had a 30-day all-cause readmission. Using propensity scores for 30-day all-cause readmission, we assembled a matched cohort of 1516 pairs of patients with and without a 30-day all-cause readmission, balanced on 34 baseline characteristics (mean age 75 years, 56% women, 24% African American).Abstract: RESULTS: During 2-12 months of follow-up after discharge from index hospitalization, all-cause mortality occurred in 41% and 27% of matched patients with and without a 30-day all-cause readmission, respectively (hazard ratio 1.68; 95% confidence interval 1.48-1.90; P <.001). This harmful association of 30-day all-cause readmission with mortality persisted during an average follow-up of 3.1 (maximum, 8.7) years (hazard ratio 1.33; 95% confidence interval 1.22-1.45; P <.001). Patients with a 30-day all-cause readmission had higher cumulative all-cause readmission (mean, 6.9 vs 5.1; P <.001), a longer cumulative length of stay (mean, 51 vs 43 days; P <.001), and a higher cumulative cost (mean, Abstract: CONCLUSIONS: Among Medicare beneficiaries hospitalized for heart failure, 30-day all-cause readmission was associated with a higher risk of subsequent all-cause mortality, higher number of cumulative all-cause readmission, longer cumulative length of stay, and higher cumulative cost.Abstract: Copyright Published by Elsevier Inc.

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