Wait List And Transplant Outcomes Of Diabetic Patients With Listed For Heart Transplantation: A Propensity-matched Analysis
HFSA ePoster Library. Alvarez P. 09/10/21; 343398; 171
Paulino Alvarez
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Abstract
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Introduction: Hospital readmission following hospitalization for heart failure (CHF) is common and challenging to prevent. Get With The Guidelines performance measures include follow-up (F/U) within 7 days, which is logistically challenging. Optimized timing of F/U may both reduce rehospitalizations and burden on providers/systems.
Hypothesis: There is no difference in 30-day hospital readmission rates between patients who F/U within 1-7 days vs. F/U within 8-14 days. Both intervals will have lower readmission rates than those who had no F/U within the first 30 days.
Methods: We retrospectively reviewed a cohort of patients discharged alive after admission for CHF between January 1, 2010 and March 13, 2021 and who had available F/U data. We examined the association between all-cause 30-day readmission type (cardiology vs. general) and timing of F/U appointment [0-7 (1W); 8-14 (2W); 15-30 days (1MO); 30-day or longer F/U (LATE)]. We used generalized estimating equations survival-time analysis models to account for clustering. We performed a subgroup analysis of admissions since 2015 controlling for risk of 30-day readmission using a prediction score previously developed using machine learning of demographic and clinical data.
Results: Among 15,766 admissions of 10,523 patients, the 30-day readmission rates were 19.2%, 18.8%, 20.7%, and 23.7% for 1W, 2W, 1MO and LATE respectively, with an overall rate of 21.1%. There was no difference in odds of readmission between 1W and 2W (OR 0.96; 95%CI 0.85-1.09; p=0.530). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.79; 95%CI 0.73-0.87; p<0.001; Figure 1) and there was a nonsignificant trend toward lower odds of readmission among those with cardiologist F/U as compared to general medicine (OR 0.91; 95%CI 0.82-1.00; P=0.053). In the subgroup analysis comprising 5,853 admissions with 30-day readmission prediction score, the odds of readmission were lower for 2W compared to 1W (OR 0.81; 95%CI 0.66-0.99; p= 0.048). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.84; 95%CI 0.73-0.98; p=0.026).
Conclusions: After discharge for CHF hospitalization, outpatient follow-up between 8 and 14 days may be the optimal timeframe for reducing the rate of readmission at 30 days within at least one health system.
Hypothesis: There is no difference in 30-day hospital readmission rates between patients who F/U within 1-7 days vs. F/U within 8-14 days. Both intervals will have lower readmission rates than those who had no F/U within the first 30 days.
Methods: We retrospectively reviewed a cohort of patients discharged alive after admission for CHF between January 1, 2010 and March 13, 2021 and who had available F/U data. We examined the association between all-cause 30-day readmission type (cardiology vs. general) and timing of F/U appointment [0-7 (1W); 8-14 (2W); 15-30 days (1MO); 30-day or longer F/U (LATE)]. We used generalized estimating equations survival-time analysis models to account for clustering. We performed a subgroup analysis of admissions since 2015 controlling for risk of 30-day readmission using a prediction score previously developed using machine learning of demographic and clinical data.
Results: Among 15,766 admissions of 10,523 patients, the 30-day readmission rates were 19.2%, 18.8%, 20.7%, and 23.7% for 1W, 2W, 1MO and LATE respectively, with an overall rate of 21.1%. There was no difference in odds of readmission between 1W and 2W (OR 0.96; 95%CI 0.85-1.09; p=0.530). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.79; 95%CI 0.73-0.87; p<0.001; Figure 1) and there was a nonsignificant trend toward lower odds of readmission among those with cardiologist F/U as compared to general medicine (OR 0.91; 95%CI 0.82-1.00; P=0.053). In the subgroup analysis comprising 5,853 admissions with 30-day readmission prediction score, the odds of readmission were lower for 2W compared to 1W (OR 0.81; 95%CI 0.66-0.99; p= 0.048). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.84; 95%CI 0.73-0.98; p=0.026).
Conclusions: After discharge for CHF hospitalization, outpatient follow-up between 8 and 14 days may be the optimal timeframe for reducing the rate of readmission at 30 days within at least one health system.
Introduction: Hospital readmission following hospitalization for heart failure (CHF) is common and challenging to prevent. Get With The Guidelines performance measures include follow-up (F/U) within 7 days, which is logistically challenging. Optimized timing of F/U may both reduce rehospitalizations and burden on providers/systems.
Hypothesis: There is no difference in 30-day hospital readmission rates between patients who F/U within 1-7 days vs. F/U within 8-14 days. Both intervals will have lower readmission rates than those who had no F/U within the first 30 days.
Methods: We retrospectively reviewed a cohort of patients discharged alive after admission for CHF between January 1, 2010 and March 13, 2021 and who had available F/U data. We examined the association between all-cause 30-day readmission type (cardiology vs. general) and timing of F/U appointment [0-7 (1W); 8-14 (2W); 15-30 days (1MO); 30-day or longer F/U (LATE)]. We used generalized estimating equations survival-time analysis models to account for clustering. We performed a subgroup analysis of admissions since 2015 controlling for risk of 30-day readmission using a prediction score previously developed using machine learning of demographic and clinical data.
Results: Among 15,766 admissions of 10,523 patients, the 30-day readmission rates were 19.2%, 18.8%, 20.7%, and 23.7% for 1W, 2W, 1MO and LATE respectively, with an overall rate of 21.1%. There was no difference in odds of readmission between 1W and 2W (OR 0.96; 95%CI 0.85-1.09; p=0.530). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.79; 95%CI 0.73-0.87; p<0.001; Figure 1) and there was a nonsignificant trend toward lower odds of readmission among those with cardiologist F/U as compared to general medicine (OR 0.91; 95%CI 0.82-1.00; P=0.053). In the subgroup analysis comprising 5,853 admissions with 30-day readmission prediction score, the odds of readmission were lower for 2W compared to 1W (OR 0.81; 95%CI 0.66-0.99; p= 0.048). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.84; 95%CI 0.73-0.98; p=0.026).
Conclusions: After discharge for CHF hospitalization, outpatient follow-up between 8 and 14 days may be the optimal timeframe for reducing the rate of readmission at 30 days within at least one health system.
Hypothesis: There is no difference in 30-day hospital readmission rates between patients who F/U within 1-7 days vs. F/U within 8-14 days. Both intervals will have lower readmission rates than those who had no F/U within the first 30 days.
Methods: We retrospectively reviewed a cohort of patients discharged alive after admission for CHF between January 1, 2010 and March 13, 2021 and who had available F/U data. We examined the association between all-cause 30-day readmission type (cardiology vs. general) and timing of F/U appointment [0-7 (1W); 8-14 (2W); 15-30 days (1MO); 30-day or longer F/U (LATE)]. We used generalized estimating equations survival-time analysis models to account for clustering. We performed a subgroup analysis of admissions since 2015 controlling for risk of 30-day readmission using a prediction score previously developed using machine learning of demographic and clinical data.
Results: Among 15,766 admissions of 10,523 patients, the 30-day readmission rates were 19.2%, 18.8%, 20.7%, and 23.7% for 1W, 2W, 1MO and LATE respectively, with an overall rate of 21.1%. There was no difference in odds of readmission between 1W and 2W (OR 0.96; 95%CI 0.85-1.09; p=0.530). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.79; 95%CI 0.73-0.87; p<0.001; Figure 1) and there was a nonsignificant trend toward lower odds of readmission among those with cardiologist F/U as compared to general medicine (OR 0.91; 95%CI 0.82-1.00; P=0.053). In the subgroup analysis comprising 5,853 admissions with 30-day readmission prediction score, the odds of readmission were lower for 2W compared to 1W (OR 0.81; 95%CI 0.66-0.99; p= 0.048). F/U at either 1W or 2W had lower odds of readmission compared to LATE (OR 0.84; 95%CI 0.73-0.98; p=0.026).
Conclusions: After discharge for CHF hospitalization, outpatient follow-up between 8 and 14 days may be the optimal timeframe for reducing the rate of readmission at 30 days within at least one health system.
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