Association Between Center Level Characteristics And 1-Month Post-LVAD Implant Risk Standardized Mortality Rates
HFSA ePoster Library. Hendren N. 09/10/21; 343384; 159
Nicholas Hendren
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Abstract
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Introduction: Early readmission after hospitalization for acute decompensated heart failure (ADHF) remains a major public health problem. Management of recurrent heart failure admissions creates a significant burden on the healthcare system and mortality rates rise with increasing heart failure admissions. Early follow up after heart failure hospitalization (HFH) is associated with reduced readmission.
Hypothesis: We hypothesized that pharmacotherapy management in the early follow up period may be associated with lower rates of readmission.
Methods: We conducted a retrospective analysis of patients scheduled for post discharge rapid follow up (RFU) after HFH at The Mount Sinai Hospital (MSH) between August 1st, 2020 and January 31th, 2021. A chart review was performed of patients who were discharged from MSH that were seen or not seen at RFU clinic. We reviewed discharge medications as well as changes made to guideline directed medical therapy and loop diuretic therapy prior to or during RFU clinic. We surveyed hospital readmissions and evaluated the association between 30-day readmission and RFU visits as well as medication adjustments.
Results: During this 6 month period, 207 patients with ADHF admissions were offered RFU appointments prior to discharge. 115 (55.6%) attended a RFU visit at which time 74 (64.3%) of these patients had medication adjustments. The most commonly adjusted medication classes were diuretics (35.1%), beta blockers (14.9%), ACEI/ARBs (14.9%), and ARNIs (12.8%). The most common newly initiated medication classes were ARNIs (35%), SGLT-2Is (25%), and MRAs (20%). Overall, 48 (23.2%) patients were readmitted within 30 days, which occurred in 18 (15.7%) of those seen at RFU and 30 (32.6%) of those that did not attend RFU. Among those seen at RFU, 30-day readmission occurred in 10 (13.5%) of those with medication adjustments and in 8 (19.5%) of those that were seen but did not have medications adjustments. Conclusion: Patients with early follow up appointments after hospitalization for acute decompensated heart failure hospitalizations had a lower rate of 30-day readmission. Pharmacotherapy adjustments were made for a majority of these patients, which included the initiation of GDMT.
Hypothesis: We hypothesized that pharmacotherapy management in the early follow up period may be associated with lower rates of readmission.
Methods: We conducted a retrospective analysis of patients scheduled for post discharge rapid follow up (RFU) after HFH at The Mount Sinai Hospital (MSH) between August 1st, 2020 and January 31th, 2021. A chart review was performed of patients who were discharged from MSH that were seen or not seen at RFU clinic. We reviewed discharge medications as well as changes made to guideline directed medical therapy and loop diuretic therapy prior to or during RFU clinic. We surveyed hospital readmissions and evaluated the association between 30-day readmission and RFU visits as well as medication adjustments.
Results: During this 6 month period, 207 patients with ADHF admissions were offered RFU appointments prior to discharge. 115 (55.6%) attended a RFU visit at which time 74 (64.3%) of these patients had medication adjustments. The most commonly adjusted medication classes were diuretics (35.1%), beta blockers (14.9%), ACEI/ARBs (14.9%), and ARNIs (12.8%). The most common newly initiated medication classes were ARNIs (35%), SGLT-2Is (25%), and MRAs (20%). Overall, 48 (23.2%) patients were readmitted within 30 days, which occurred in 18 (15.7%) of those seen at RFU and 30 (32.6%) of those that did not attend RFU. Among those seen at RFU, 30-day readmission occurred in 10 (13.5%) of those with medication adjustments and in 8 (19.5%) of those that were seen but did not have medications adjustments. Conclusion: Patients with early follow up appointments after hospitalization for acute decompensated heart failure hospitalizations had a lower rate of 30-day readmission. Pharmacotherapy adjustments were made for a majority of these patients, which included the initiation of GDMT.
Introduction: Early readmission after hospitalization for acute decompensated heart failure (ADHF) remains a major public health problem. Management of recurrent heart failure admissions creates a significant burden on the healthcare system and mortality rates rise with increasing heart failure admissions. Early follow up after heart failure hospitalization (HFH) is associated with reduced readmission.
Hypothesis: We hypothesized that pharmacotherapy management in the early follow up period may be associated with lower rates of readmission.
Methods: We conducted a retrospective analysis of patients scheduled for post discharge rapid follow up (RFU) after HFH at The Mount Sinai Hospital (MSH) between August 1st, 2020 and January 31th, 2021. A chart review was performed of patients who were discharged from MSH that were seen or not seen at RFU clinic. We reviewed discharge medications as well as changes made to guideline directed medical therapy and loop diuretic therapy prior to or during RFU clinic. We surveyed hospital readmissions and evaluated the association between 30-day readmission and RFU visits as well as medication adjustments.
Results: During this 6 month period, 207 patients with ADHF admissions were offered RFU appointments prior to discharge. 115 (55.6%) attended a RFU visit at which time 74 (64.3%) of these patients had medication adjustments. The most commonly adjusted medication classes were diuretics (35.1%), beta blockers (14.9%), ACEI/ARBs (14.9%), and ARNIs (12.8%). The most common newly initiated medication classes were ARNIs (35%), SGLT-2Is (25%), and MRAs (20%). Overall, 48 (23.2%) patients were readmitted within 30 days, which occurred in 18 (15.7%) of those seen at RFU and 30 (32.6%) of those that did not attend RFU. Among those seen at RFU, 30-day readmission occurred in 10 (13.5%) of those with medication adjustments and in 8 (19.5%) of those that were seen but did not have medications adjustments. Conclusion: Patients with early follow up appointments after hospitalization for acute decompensated heart failure hospitalizations had a lower rate of 30-day readmission. Pharmacotherapy adjustments were made for a majority of these patients, which included the initiation of GDMT.
Hypothesis: We hypothesized that pharmacotherapy management in the early follow up period may be associated with lower rates of readmission.
Methods: We conducted a retrospective analysis of patients scheduled for post discharge rapid follow up (RFU) after HFH at The Mount Sinai Hospital (MSH) between August 1st, 2020 and January 31th, 2021. A chart review was performed of patients who were discharged from MSH that were seen or not seen at RFU clinic. We reviewed discharge medications as well as changes made to guideline directed medical therapy and loop diuretic therapy prior to or during RFU clinic. We surveyed hospital readmissions and evaluated the association between 30-day readmission and RFU visits as well as medication adjustments.
Results: During this 6 month period, 207 patients with ADHF admissions were offered RFU appointments prior to discharge. 115 (55.6%) attended a RFU visit at which time 74 (64.3%) of these patients had medication adjustments. The most commonly adjusted medication classes were diuretics (35.1%), beta blockers (14.9%), ACEI/ARBs (14.9%), and ARNIs (12.8%). The most common newly initiated medication classes were ARNIs (35%), SGLT-2Is (25%), and MRAs (20%). Overall, 48 (23.2%) patients were readmitted within 30 days, which occurred in 18 (15.7%) of those seen at RFU and 30 (32.6%) of those that did not attend RFU. Among those seen at RFU, 30-day readmission occurred in 10 (13.5%) of those with medication adjustments and in 8 (19.5%) of those that were seen but did not have medications adjustments. Conclusion: Patients with early follow up appointments after hospitalization for acute decompensated heart failure hospitalizations had a lower rate of 30-day readmission. Pharmacotherapy adjustments were made for a majority of these patients, which included the initiation of GDMT.
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