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

Donald P. McLaren, Roy Jones, Ronald Plotnik, Wojciech Zareba, Scott McIntosh, Jeffrey Alexis, Leway Chen, Robert Block, Charles J. Lowenstein, Valentina Kutyifa

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hospital readmission is a significant health burden. More than 20% of heart failure (HF) patients are readmitted within 30 days of discharge leading to billions of dollars in health care expenditures. However, the role of prior hospital admissions to predict 30-day readmission for HF patients is not fully understood. Methods: We retrospectively analyzed HF hospitalization data for 4 years at a single medical center. Association between prior admission and 30-day readmission after HF hospitalization was assessed using a multivariate logistic regression model. Results: A total of 1,999 patients with index HF hospitalizations were identified, and 366 of them (18%) were readmitted within 30 days. The rate of readmission was 14%, 20%, and 33% in patients with 0, 1, ≥ 2 prior admissions. Patients with one prior admission had a 50% higher risk (confidence interval [CI] 1.10–2.05, p = 0.011) for readmission, while those with ≥ 2 prior admissions had a more than 3-fold increase in readmission (CI 2.27–4.09, p <0.001), after adjustments for relevant clinical covariates. Prior hospital admission provided incremental value in predicting readmissions, shown by the significant improvement in the readmission predictive model (C-statistics increased from 0.57 to 0.63). However, neither the length of stay nor recency of prior admission was a significant factor in predicting readmissions. Conclusions: Hospital admission prior to an index HF hospitalization is associated with a significantly increased risk for 30-day hospital readmission and could be used to identify patients at high-risk for readmission and potentially target interventions to reduce the risk of readmission for these patients.

Original languageEnglish (US)
Pages (from-to)155-162
Number of pages8
JournalCardiology Journal
Volume23
Issue number2
DOIs
StatePublished - 2016
Externally publishedYes

Keywords

  • Heart failure
  • Predictive model
  • Prior admissions
  • Readmissions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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