scholarly journals Prior hospital admission predicts thirty-day hospital readmission for heart failure patients

2016 ◽  
Vol 23 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Donald P. McLaren ◽  
Roy Jones ◽  
Ronald Plotnik ◽  
Wojciech Zareba ◽  
Scott McIntosh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Hospital Readmission ◽  
Day Hospital ◽  
Heart Failure Patients

scholarly journals Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients

2019 ◽  
Author(s):  
Camila Sarteschi ◽  
Wayner Viera de Souza ◽  
Carolina Medeiros ◽  
Paulo Sergio Rodrigues Oliveira ◽  
Silvia Marinho Martins ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Decompensated Heart Failure ◽  
Day Hospital ◽  
Post Discharge ◽  
Heart Failure Patients

scholarly journals Impact of non-cardiovascular disease burden on thirty-day hospital readmission in heart failure patients

2018 ◽  
Vol 25 (6) ◽  
pp. 691-700 ◽  
Author(s):  
Valentina Kutyifa ◽  
John Rice ◽  
Roy Jones ◽  
Andrew Mathias ◽  
Ayhan Yoruk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Hospital Readmission ◽  
Disease Burden ◽  
Day Hospital ◽  
Heart Failure Patients

scholarly journals IMRS-HF: A CLINICAL DECISION TOOL FOR PREDICTING 30-DAY HOSPITAL READMISSION AMONG HEART FAILURE PATIENTS

2013 ◽  
Vol 61 (10) ◽  
pp. E629 ◽  
Author(s):  
Benjamin Davies Horne ◽  
Jason Lappe ◽  
Abdallah Kfoury ◽  
Deborah Budge ◽  
Rami Alharethi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Clinical Decision ◽  
Day Hospital ◽  
Decision Tool ◽  
Heart Failure Patients

Development and validation of the Tool for Pharmacists to Predict 30-day hospital readmission in patients with Heart Failure (ToPP-HF)

2021 ◽  
Author(s):  
Melissa R Riester ◽  
Laura McAuliffe ◽  
Christine Collins ◽  
Andrew R Zullo
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Hospital Readmission ◽  
Left Ventricular Ejection ◽  
Day Hospital ◽  
High Risk Patients ◽  
C Statistic ◽  
Patients With Heart Failure ◽  
Risk Patients ◽  
Development And Validation

Abstract Purpose Pharmacists are well positioned to provide transitions of care (TOC) services to patients with heart failure (HF); however, hospitalizations for patients with HF likely exceed the capacity of a TOC pharmacist. We developed and validated a tool to help pharmacists efficiently identify high-risk patients with HF and maximize their potential impact by intervening on patients at the highest risk for 30-day all-cause readmission. Methods We conducted a retrospective cohort study including adults with HF admitted to a health system between October 1, 2016, and October 31, 2019. We randomly divided the cohort into development (n = 2,114) and validation (n = 1,089) subcohorts. Nine models were applied to select the most important predictors of 30-day readmission. The final tool, called the Tool for Pharmacists to Predict 30-day hospital readmission in patients with Heart Failure (ToPP-HF) relied upon multivariable logistic regression. We assessed discriminative ability using the C statistic and calibration using the Hosmer-Lemeshow goodness-of-fit test. Results The risk of 30-day all-cause readmission was 15.7% (n = 331) and 18.8% (n = 205) in the development and validation subcohorts, respectively. The ToPP-HF tool included 13 variables: number of hospital admissions in previous 6 months; admission diagnosis of HF; number of scheduled medications; chronic obstructive pulmonary disease diagnosis; number of comorbidities; estimated glomerular filtration rate; hospital length of stay; left ventricular ejection fraction; critical care requirement; renin-angiotensin-aldosterone system inhibitor use; antiarrhythmic use; hypokalemia; and serum sodium. Discriminatory performance (C statistic of 0.69; 95% confidence interval [CI], 0.65-0.73) and calibration (Hosmer-Lemeshow P = 0.28) were good. Conclusions The ToPP-HF performs well and can help pharmacists identify high-risk patients with HF most likely to benefit from TOC services.

Abstract 149: Care for Heart Failure Patients at the End of Life: Hospital Readmission and Mortality Amongst Heart Failure Patients Discharged to Hospice

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Haider J Warraich ◽  
Adam Devore ◽  
Haolin Xu ◽  
Roland Matsouaka ◽  
Paul Heidenreich ◽  
...  
Keyword(s):  
Heart Failure ◽  
End Of Life ◽  
Median Survival ◽  
Hospital Readmission ◽  
Discharge Rate ◽  
Care Plan ◽  
High Risk Population ◽  
White Race ◽  
Heart Failure Patients ◽  
Hospice Patients

Background: While 1 in 10 patients hospitalized with heart failure (HF) die within 30 days, end-of-life care for this high-risk population is not well described. Methods: We analyzed patients discharged alive from the Get With The Guidelines-HF registry between 2005-2014, linked to Medicare claims. We compared patients discharged to hospice to non-hospice “advanced HF” patients (ejection fraction ≤25% and either on inotropes, sodium ≤130, blood urea nitrogen ≥45 mg/dL, systolic blood pressure ≤90 mmHg or comfort measures) and to other GWTG-HF patients. Results: Of 121,990 US patients, hospice patients (n=4588, 2164 facility-based, 2424 home hospice) compared with advanced HF (n=4357) and others (113,045) were older (median age 86 years vs 78 years vs 81 years), more likely white race (88% vs 80% vs 82%), have intravenous loop diuretics used (74% vs 57% vs 63%), have an advanced care plan/surrogate decision maker discussed or documented (76% vs 62% vs 66%), had more dyspnea at rest (55% vs 46% vs 48%) and worse/unchanged symptoms at discharge (35% vs 2% vs 1%) (all p<0.01). Discharge to hospice increased from 2% (n=109) in 2005 to 5% (n=968) in 2014. Median survival in hospice was 11 days (25 th , 75 th percentile: 3, 65 days) compared with advanced HF (318 days) and others (754 days); 34% of patients discharged to a hospice facility and 12% to home hospice died in <3 days. (Figure) Median survival in hospice did not change significantly from 2005 to 2014. Hospital readmission at 30 days was 4% among hospice, 27% for advanced HF, and 22% for others. Median hospice discharge rate was 3.0 (0.7, 5.5). Hospice discharges had lower adjusted hazards of all-cause readmission (hospice compared with others: advanced HF odd ratio (OR) 0.15 (95% confidence interval (CI) 0.13-0.18), others OR 0.15 (95% CI 0.13-0.18). Hospice patients also had lower 6-month and 1-year readmission rate. Non-white race (OR 1.59 [95% CI 1.18-2.17]) and younger age (OR per 5 years 1.18 [95% CI 1.10-1.27)] were the strongest predictors of readmission from hospice. Conclusion: Hospice use in patients hospitalized with HF is limited but increasing. Few hospice patients are rehospitalized and almost a quarter die within 3 days of discharge. These findings may inform interventions to improve hospice care for HF patients.

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