Comorbidities, discharge to rehab facility predict 30-day readmission in HF patients

Discharge to a rehabilitation facility or home and certain comorbidities are significantly associated with a higher risk of 30-day all-cause readmission in patients with heart failure (HF), reveals a US study.

“Identified predictors in the patient population with HF at our institution may be used to target patients at increased risk of all-cause readmission within 30 days,” the investigators said.

A retrospective chart review of patients aged ≥18 years admitted with HF and all subsequent readmissions between 1 October 2015 and 30 September 2017 was conducted to determine the impact of transitions of care (TOC) service on 30-day all-cause and HF readmission and to identify predictive risk factors for 30-day all-cause readmission. The investigators developed a weighted logistic regression to identify these risk factors.

Analysis by TOC service involvement revealed no significant differences in the rates of all-cause or HF readmission. Significant risk factors for 30-day all-cause readmission were discharge to a rehabilitation facility (odds ratio, 9.3) or home with home health (odds ratio, 1.6) compared with home with self-care. In addition, comorbidities including diabetes, coronary artery disease, and aortic stenosis were significantly associated with a higher risk of 30-day all-cause readmission.

On the other hand, use of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and spironolactone correlated with a lower risk of 30-day all-cause readmission.

“HF is a prevalent and costly disease state for adult Americans, with 30-day readmissions rates for patients with HF utilized to limit hospital compensation,” the investigators said.