Andrea Driscoll1, Diem Dinh2, David Prior3, David Kaye4, David Hare5, Christopher Neil6, Siobhan Lockwood7, Angela Brennan2, Jeff Lefkovits2, Harriet Carruthers2, John Amerena8, Jennifer C Cooke9, Gautam Vaddadi10, Voltaire Nadurata11, Christopher M Reid12. 1. School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia; School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia; Department of Cardiology, Austin Health, Melbourne, Vic, Australia. Electronic address: andrea.driscoll@deakin.edu.au. 2. School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia. 3. Department of Cardiology, St Vincents Hospital, Melbourne, Vic, Australia; School of Medicine, University of Melbourne, Melbourne, Vic, Australia. 4. Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Department of Cardiology, Alfred Health, Melbourne, Vic, Australia. 5. Department of Cardiology, Austin Health, Melbourne, Vic, Australia; School of Medicine, University of Melbourne, Melbourne, Vic, Australia. 6. Department of Cardiology, Western Health, Melbourne, Vic, Australia; School of Medicine, University of Melbourne, Melbourne, Vic, Australia. 7. Department of Cardiology, Monash Health, Melbourne, Vic, Australia. 8. Department of Cardiology, Barwon Health, Geelong, Vic, Australia. 9. Department of Cardiology, Eastern Health, Melbourne, Vic, Australia; School of Medicine, Monash University, Melbourne, Vic, Australia. 10. Department of Cardiology, Northern Health, Melbourne, Vic, Australia. 11. Department of Cardiology, Bendigo Health, Bendigo,Vic, Australia. 12. School of Public Health, Curtin University, Perth, WA, Australia.
Abstract
BACKGROUND: Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. METHODS: This was a prospective, observational, non-randomised study of consecutive patients hospitalised with acute HF to one of 16 Victorian hospitals over a 30-day period each year and followed up for 30 days post-discharge. The project was conducted annually over three consecutive years from 2015 to 2017. RESULTS: Of the 1,197 patients, 56.3% were male with an average age of 77±13.23 years. Over half of the patients (711, 62.5%) were referred to an outpatient clinic and a third (391, 34.4%) to a HF disease management program. In-hospital mortality was 5.1% with 30 day-mortality of 9% and readmission rate of 24.4%. Patients who experienced a subsequent readmission less than 10 days post-discharge and between 11 and 20 days post-discharge had a five- to six-fold increase in risk of mortality (adjusted OR 5.02, 95% CI 2.11-11.97; OR 6.45, 95% CI 2.69-15.42; respectively) compared to patients who were not readmitted to hospital. An outpatient appointment within 30 days post-discharge significantly reduced the risk of 30-day mortality by 81% (95% CI 0.09-0.43). CONCLUSION: Patients admitted to hospital with AHF who experience a subsequent readmission within 20 days post-discharge are at increased risk of dying. However, early follow-up post-discharge may reduce this risk. Early post-discharge follow-up is vital to address this vulnerable period after a HF admission.
BACKGROUND:Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. METHODS: This was a prospective, observational, non-randomised study of consecutive patients hospitalised with acute HF to one of 16 Victorian hospitals over a 30-day period each year and followed up for 30 days post-discharge. The project was conducted annually over three consecutive years from 2015 to 2017. RESULTS: Of the 1,197 patients, 56.3% were male with an average age of 77±13.23 years. Over half of the patients (711, 62.5%) were referred to an outpatient clinic and a third (391, 34.4%) to a HF disease management program. In-hospital mortality was 5.1% with 30 day-mortality of 9% and readmission rate of 24.4%. Patients who experienced a subsequent readmission less than 10 days post-discharge and between 11 and 20 days post-discharge had a five- to six-fold increase in risk of mortality (adjusted OR 5.02, 95% CI 2.11-11.97; OR 6.45, 95% CI 2.69-15.42; respectively) compared to patients who were not readmitted to hospital. An outpatient appointment within 30 days post-discharge significantly reduced the risk of 30-day mortality by 81% (95% CI 0.09-0.43). CONCLUSION:Patients admitted to hospital with AHF who experience a subsequent readmission within 20 days post-discharge are at increased risk of dying. However, early follow-up post-discharge may reduce this risk. Early post-discharge follow-up is vital to address this vulnerable period after a HF admission.
Authors: Miguel Benito-Lozano; Pedro López-Ayala; Sergio Rodríguez; Víctor Gil; Pere Llorens; Ana Yufera; Javier Jacob; Lissete Travería-Becker; Ivo Strebel; Francisco Javier Lucas-Imbernon; Josep Tost; Ángeles López-Hernández; Beatriz Rodríguez; Marta Fuentes; Susana Sánchez-Ramón; Sergio Herrera-Mateo; Alfons Aguirre; M Isabel Alonso; José Pavón; M Luisa López-Grima; Begoña Espinosa; Christian Mueller; Guillermo Burillo-Putze; Òscar Miró Journal: Intern Emerg Med Date: 2022-09-01 Impact factor: 5.472
Authors: Catherine Giuliano; Don Vicendese; Sara Vogrin; Rebecca Lane; Andrea Driscoll; Diem Dinh; Katie Palmer; Itamar Levinger; Christopher Neil Journal: J Clin Med Date: 2022-02-24 Impact factor: 4.241