One- to 10-Day Versus 11- to 30-Day All-Cause Readmission and Mortality in Older Patients With Heart Failure. - 2019

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Copyright Published by Elsevier Inc. Heart failure (HF) is the leading cause for 30-day all-cause readmission in older Medicare beneficiaries and 30-day all-cause readmission is associated with a higher risk of mortality. In the current analysis, we examined if that association varied by timing of 30-day all-cause readmission. Of the 8,049 Medicare beneficiaries hospitalized for HF, 1,688 had 30-day all-cause readmissions, of whom 1,519 were alive at 30 days. Of these, 626 (41%) had early (first 10 days) 30-day readmission. Propensity scores for early 30-day readmission, estimated for all 1,519 patients, were used to assemble a matched cohort of 596 pairs of patients with early versus late (11 to 30 days) all-cause readmission balanced on 34 baseline characteristics. Two-year all-cause mortality occurred in 51% and 57% of matched patients with early versus late 30-day all-cause readmissions, respectively (hazard ratio [HR] associated with late 30-day readmission, 1.22; 95% confidence interval [CI], 1.04 to 1.42; p=0.014). This association was not observed in the subset of 436 patients whose 30-day all-cause readmission was due to HF (HR, 1.01; 95% CI, 0.79 to 1.28; p=0.963), but was observed in the subset of 756 patients whose 30-day all-cause readmission was not due to HF (HR, 1.37; 95% CI, 1.12 to 1.67; p=0.002; p for interaction, 0.057). In conclusion, in a high-risk subset of older hospitalized HF patients readmitted within 30 days, readmission during 11 to 30 (vs 1 to 10) days was associated with a higher risk of death and this association appeared to be more pronounced in those readmitted for non-HF-related reasons.


English

0002-9149

10.1016/j.amjcard.2019.03.007 [doi] S0002-9149(19)30302-9 [pii]


*Heart Failure/mo [Mortality]
*Patient Readmission/sn [Statistics & Numerical Data]
Aged
Aged, 80 and over
Cohort Studies
Female
Heart Failure/co [Complications]
Humans
Male
Middle Aged
Time Factors


MedStar Heart & Vascular Institute


Journal Article