Tamra Keeney1, Diane U Jette2, Howard Cabral3, Alan M Jette1. 1. School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, Massachusetts. 2. Department of Physical Therapy, MGH Institute of Health Professions, Boston, Massachusetts. 3. Boston University School of Public Health, Boston, Massachusetts.
Abstract
BACKGROUND AND PURPOSE: Although there have been decreases noted in 30-day readmission rates for persons with heart failure since enactment of the Hospital Readmissions Reduction Program, costs related to heart failure readmissions remain high. Consequently, there is a need to better identify persons with heart failure who are at risk for 30-day hospital readmission. Therefore, this study aimed to compare the ability of measures of function and frailty to predict 30-day hospital readmissions for adults 65 years and older with heart failure. METHODS: Secondary data analysis using the 2011 National Health and Aging Trends Study analysis merged with Medicare claims data. Logistic regression modeling was used to compare the ability of function (Short Physical Performance Battery) and frailty (Fried's Physical Frailty Phenotype) to predict 30-day readmission. Receiver operating characteristic curves were constructed to examine the ability of function and frailty to identify those who were readmitted. RESULTS AND DISCUSSION: Frailty and function demonstrated comparable ability to predict 30-day readmissions (R2 = 0.087 and R2 = 0.087, respectively). Neither measure identified persons at risk for readmission (AUCSPPB = 0.608; AUCPFP = 0.587). CONCLUSIONS: Functional assessment demonstrated comparable ability to predict 30-day readmissions in persons with heart failure compared with frailty. However, neither measure was able to identify persons at high risk for readmission. Although frailty status is emphasized in research for older adults with heart failure, functional status is an important patient-level factor associated with readmission.
BACKGROUND AND PURPOSE: Although there have been decreases noted in 30-day readmission rates for persons with heart failure since enactment of the Hospital Readmissions Reduction Program, costs related to heart failure readmissions remain high. Consequently, there is a need to better identify persons with heart failure who are at risk for 30-day hospital readmission. Therefore, this study aimed to compare the ability of measures of function and frailty to predict 30-day hospital readmissions for adults 65 years and older with heart failure. METHODS: Secondary data analysis using the 2011 National Health and Aging Trends Study analysis merged with Medicare claims data. Logistic regression modeling was used to compare the ability of function (Short Physical Performance Battery) and frailty (Fried's Physical Frailty Phenotype) to predict 30-day readmission. Receiver operating characteristic curves were constructed to examine the ability of function and frailty to identify those who were readmitted. RESULTS AND DISCUSSION: Frailty and function demonstrated comparable ability to predict 30-day readmissions (R2 = 0.087 and R2 = 0.087, respectively). Neither measure identified persons at risk for readmission (AUCSPPB = 0.608; AUCPFP = 0.587). CONCLUSIONS: Functional assessment demonstrated comparable ability to predict 30-day readmissions in persons with heart failure compared with frailty. However, neither measure was able to identify persons at high risk for readmission. Although frailty status is emphasized in research for older adults with heart failure, functional status is an important patient-level factor associated with readmission.
Authors: B W Penninx; L Ferrucci; S G Leveille; T Rantanen; M Pahor; J M Guralnik Journal: J Gerontol A Biol Sci Med Sci Date: 2000-11 Impact factor: 6.053
Authors: Melissa O'Connor; Christopher M Murtaugh; Shivani Shah; Yolanda Barrón-Vaya; Kathryn H Bowles; Timothy R Peng; Carolyn W Zhu; Penny H Feldman Journal: Med Care Res Rev Date: 2015-07-14 Impact factor: 3.929
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: Karen Bandeen-Roche; Christopher L Seplaki; Jin Huang; Brian Buta; Rita R Kalyani; Ravi Varadhan; Qian-Li Xue; Jeremy D Walston; Judith D Kasper Journal: J Gerontol A Biol Sci Med Sci Date: 2015-08-21 Impact factor: 6.053
Authors: María T Vidán; Vendula Blaya-Novakova; Elísabet Sánchez; Javier Ortiz; José A Serra-Rexach; Héctor Bueno Journal: Eur J Heart Fail Date: 2016-04-12 Impact factor: 15.534
Authors: Jonathan Afilalo; Karen P Alexander; Michael J Mack; Mathew S Maurer; Philip Green; Larry A Allen; Jeffrey J Popma; Luigi Ferrucci; Daniel E Forman Journal: J Am Coll Cardiol Date: 2013-11-27 Impact factor: 24.094
Authors: Marla K Beauchamp; Catherine T Schmidt; Mette M Pedersen; Jonathan F Bean; Alan M Jette Journal: BMC Geriatr Date: 2014-01-29 Impact factor: 3.921
Authors: Oanh Kieu Nguyen; Colin Washington; Christopher R Clark; Michael E Miller; Vivek A Patel; Ethan A Halm; Anil N Makam Journal: J Gen Intern Med Date: 2021-01-14 Impact factor: 6.473