Lucía Fernandez-Gasso1, Lauro Hernando-Arizaleta2, Joaquín A Palomar-Rodríguez2, M Victoria Abellán-Pérez3, Domingo A Pascual-Figal4. 1. Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Spain. 2. Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Murcia, Spain. 3. Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Murcia, Spain; Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, Spain. 4. Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; CIBER in Cardiovascular Diseases (CIBERCV), Madrid, Spain. Electronic address: dpascual@um.es.
Abstract
BACKGROUND: Reliable data are necessary if the burden of early readmissions following hospitalization for heart failure (HF) is to be addressed. We studied unplanned 30-day readmissions, their causes and timing over an 11-year period, using population-based linked data. METHODS: All hospitalizations from 2003 to 2013 were analyzed by using administrative linked data based on the Minimum Basic Set discharge registry of the Department of Health (Region of Murcia, Spain). Index hospitalizations with HF as principal diagnosis (n=27,581) were identified. Transfers between centers were merged into one discharge. Readmissions were defined as unplanned admissions to any hospital within 30-days after discharge. RESULTS: In the 2003-2013 period, 30-day readmission rates had a relative mean annual growth of +1.36%, increasing from 17.6% to 22.1%, with similar trends for cardiovascular and non-cardiovascular causes. The figure of 22.1% decreased to 19.8% when only same-hospital readmissions were considered. Most readmissions were due to cardiovascular causes (60%), HF being the most common single cause (34%). The timing of readmission shows an early peak on the fourth day post discharge (+13.29%) due to causes other than HF, followed by a gradual decline (-3.32%); readmission for HF decreased steadily from the first day (-2.22%). Readmission for HF (12.7%) or non-cardiovascular causes (13.3%) had higher in-hospital mortality rates than the index hospitalization (9.2%, p<0.001). Age and comorbidity burden were the main predictors of any readmission, but the performance of a predictive model was poor. CONCLUSION: These findings support the need for population-based strategies to reduce the burden of early-unplanned readmissions.
BACKGROUND: Reliable data are necessary if the burden of early readmissions following hospitalization for heart failure (HF) is to be addressed. We studied unplanned 30-day readmissions, their causes and timing over an 11-year period, using population-based linked data. METHODS: All hospitalizations from 2003 to 2013 were analyzed by using administrative linked data based on the Minimum Basic Set discharge registry of the Department of Health (Region of Murcia, Spain). Index hospitalizations with HF as principal diagnosis (n=27,581) were identified. Transfers between centers were merged into one discharge. Readmissions were defined as unplanned admissions to any hospital within 30-days after discharge. RESULTS: In the 2003-2013 period, 30-day readmission rates had a relative mean annual growth of +1.36%, increasing from 17.6% to 22.1%, with similar trends for cardiovascular and non-cardiovascular causes. The figure of 22.1% decreased to 19.8% when only same-hospital readmissions were considered. Most readmissions were due to cardiovascular causes (60%), HF being the most common single cause (34%). The timing of readmission shows an early peak on the fourth day post discharge (+13.29%) due to causes other than HF, followed by a gradual decline (-3.32%); readmission for HF decreased steadily from the first day (-2.22%). Readmission for HF (12.7%) or non-cardiovascular causes (13.3%) had higher in-hospital mortality rates than the index hospitalization (9.2%, p<0.001). Age and comorbidity burden were the main predictors of any readmission, but the performance of a predictive model was poor. CONCLUSION: These findings support the need for population-based strategies to reduce the burden of early-unplanned readmissions.
Authors: Daniel Fernández-Bergés; Reyes González-Fernández; Francisco Javier Félix-Redondo; José Arevalo Lorido; Lorena Yeguas Rosa; Miriam Hernández-González; Alessia Rubini; Miguel Galán Montejano; María Carmen Gamero; Luis Lozano Mera Journal: Aten Primaria Date: 2022-05-13 Impact factor: 2.206
Authors: Jenice Guzman-Clark; Melissa M Farmer; Bonnie J Wakefield; Benjamin Viernes; Maria Yefimova; Martin L Lee; Theodore J Hahn Journal: Nurs Outlook Date: 2020-12-02 Impact factor: 3.250