Junaid Nizamuddin1, Atul Gupta1, Vijal Patel1, Mohammed Minhaj1, Sarah L Nizamuddin1, Ariel L Mueller2, Heba Naseem3, Avery Tung1, Sarosh Rana3, Sajid Shahul4. 1. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL. 2. Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. 3. Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL. 4. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL. Electronic address: sshahul1@dacc.uchicago.edu.
Abstract
OBJECTIVE: To study the association between hypertensive diseases of pregnancy and immediate postpartum development of heart failure in a large national database. PATIENTS AND METHODS: Using the 2013 to 2014 National Readmissions Database, which covered admissions from January 1 through September 30 in years 2013 and 2014, we examined 90-day readmission rates in parturients with a diagnosis of hypertensive disease of pregnancy who were discharged after delivery. The primary outcome was the association between the presence of hypertensive disease of pregnancy and readmission with heart failure within 90 days of delivery discharge. Secondary outcomes included readmission mortality, time between delivery discharge and readmission, length of stay, and costs of readmission. RESULTS: Women with hypertensive disease of pregnancy were more likely to be readmitted with heart failure (1809 of 25,908 readmissions (7.0%) vs 2622 of 89,660 readmissions (2.9%); P<.001). This difference persisted after adjustment for potential cofounders (6.3% vs 3.1%; odds ratio, 2.15; 95% CI, 1.92-2.40; P<.001). Women with a diagnosis of heart failure at readmission were readmitted sooner (11 days vs 23 days; P<.001) and had a longer length of stay (4 days vs 3 days; P<.001) and higher costs of readmission ($10,361 vs $6977; P<.001) than did women without a diagnosis of heart failure. CONCLUSION: Parturients with hypertensive disease of pregnancy were more likely to be readmitted with heart failure within 90 days of delivery. Most patients readmitted with heart failure were readmitted within 2 weeks of discharge after delivery. Patients readmitted with heart failure had substantial health care expenditures.
OBJECTIVE: To study the association between hypertensive diseases of pregnancy and immediate postpartum development of heart failure in a large national database. PATIENTS AND METHODS: Using the 2013 to 2014 National Readmissions Database, which covered admissions from January 1 through September 30 in years 2013 and 2014, we examined 90-day readmission rates in parturients with a diagnosis of hypertensive disease of pregnancy who were discharged after delivery. The primary outcome was the association between the presence of hypertensive disease of pregnancy and readmission with heart failure within 90 days of delivery discharge. Secondary outcomes included readmission mortality, time between delivery discharge and readmission, length of stay, and costs of readmission. RESULTS:Women with hypertensive disease of pregnancy were more likely to be readmitted with heart failure (1809 of 25,908 readmissions (7.0%) vs 2622 of 89,660 readmissions (2.9%); P<.001). This difference persisted after adjustment for potential cofounders (6.3% vs 3.1%; odds ratio, 2.15; 95% CI, 1.92-2.40; P<.001). Women with a diagnosis of heart failure at readmission were readmitted sooner (11 days vs 23 days; P<.001) and had a longer length of stay (4 days vs 3 days; P<.001) and higher costs of readmission ($10,361 vs $6977; P<.001) than did women without a diagnosis of heart failure. CONCLUSION: Parturients with hypertensive disease of pregnancy were more likely to be readmitted with heart failure within 90 days of delivery. Most patients readmitted with heart failure were readmitted within 2 weeks of discharge after delivery. Patients readmitted with heart failure had substantial health care expenditures.
Authors: Victoria A deMartelly; John Dreixler; Avery Tung; Ariel Mueller; Sarah Heimberger; Abid A Fazal; Heba Naseem; Roberto Lang; Eric Kruse; Megan Yamat; Joey P Granger; Bhavisha A Bakrania; Javier Rodriguez-Kovacs; Sarosh Rana; Sajid Shahul Journal: J Am Heart Assoc Date: 2021-02-23 Impact factor: 5.501