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Examining the Burden of Potentially Avoidable Heart Failure Hospitalizations.

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Citation: Clinicoeconomics & Outcomes Research. 15:721-731, 2023.PMID: 37795407Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXED | Year: 2023 ISSN:

1178-6981

Name of journal: ClinicoEconomics and outcomes research : CEORAbstract: Background: Two-thirds of the 1 million annual US CHF hospitalizations are for diuresis only; some may be avoidable. We describe a population of low-severity short-stay (</= 4 days) patients admitted for CHF.Conclusion: Among short-stay CHF patients, nearly 1/2 meet criteria for CHF-L, and are mainly admitted for fluid management. Avoiding these admissions could result in substantial savings. Copyright © 2023 Zilberberg et al.Methods: We conducted a retrospective cohort study within the Premier Healthcare Database, 2016-2021. CHF was defined via an administrative code algorithm. High severity (CHF-H) was marked by cardiogenic shock, the need for respiratory or circulatory support, and/or a Charlson comorbidity index >2. We compared baseline characteristics, processes of care, and outcomes in low-severity (CHF-L) to CHF-H.Results: Among 301,672 short-stay CHF patients, 135,304 (44.8%) were CHF-L. Compared to CHF-H, CHF-L was younger (70.5 +/- 14.1 vs 72.1 +/- 13.6 years, p < 0.001), more commonly female (48.6% vs 45.8%, p < 0.001), and more likely to receive IV ACE-I/ARB agents (0.5% vs 0.4%, p = 0.003). Most other IV medications were more common in CHF-H, and anticoagulation was the most prevalent non-diuretic IV therapy in both groups (23.8% vs 33.3%, p < 0.001). Hospital mortality (0.2% vs 1.5%, p < 0.001) and CHF-related 30-day readmissions (8.1% vs 10.5%, p < 0.001) were lower in CHF-L than CHF-H.All authors: Zilberberg MD, Nathanson BH, Sulham K, Mohr JF, Goodwin M, Shorr AFFiscal year: FY2024 Digital Object Identifier:

https://dx.doi.org/10.2147/CEOR.S423868

Date added to catalog: 2023-12-20

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	37795407	Available		37795407

Background: Two-thirds of the 1 million annual US CHF hospitalizations are for diuresis only; some may be avoidable. We describe a population of low-severity short-stay (</= 4 days) patients admitted for CHF.

Conclusion: Among short-stay CHF patients, nearly 1/2 meet criteria for CHF-L, and are mainly admitted for fluid management. Avoiding these admissions could result in substantial savings. Copyright © 2023 Zilberberg et al.

Methods: We conducted a retrospective cohort study within the Premier Healthcare Database, 2016-2021. CHF was defined via an administrative code algorithm. High severity (CHF-H) was marked by cardiogenic shock, the need for respiratory or circulatory support, and/or a Charlson comorbidity index >2. We compared baseline characteristics, processes of care, and outcomes in low-severity (CHF-L) to CHF-H.

Results: Among 301,672 short-stay CHF patients, 135,304 (44.8%) were CHF-L. Compared to CHF-H, CHF-L was younger (70.5 +/- 14.1 vs 72.1 +/- 13.6 years, p < 0.001), more commonly female (48.6% vs 45.8%, p < 0.001), and more likely to receive IV ACE-I/ARB agents (0.5% vs 0.4%, p = 0.003). Most other IV medications were more common in CHF-H, and anticoagulation was the most prevalent non-diuretic IV therapy in both groups (23.8% vs 33.3%, p < 0.001). Hospital mortality (0.2% vs 1.5%, p < 0.001) and CHF-related 30-day readmissions (8.1% vs 10.5%, p < 0.001) were lower in CHF-L than CHF-H.

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