Relation of a Simple Cardiac Co-Morbidity Count and Cardiovascular Readmission After a Heart Failure Hospitalization.

TitleRelation of a Simple Cardiac Co-Morbidity Count and Cardiovascular Readmission After a Heart Failure Hospitalization.
Publication TypeJournal Article
Year of Publication2020
AuthorsVisaria A, Balkan L, Pinheiro LC, Bryan J, Banerjee S, Sterling MR, Krishnan U, Horn EM, Safford MM, Goyal P
JournalAm J Cardiol
Volume125
Issue10
Pagination1529-1535
Date Published2020 May 15
ISSN1879-1913
KeywordsAge Factors, Aged, Algorithms, Female, Heart Failure, Hospital Mortality, Humans, Male, Middle Aged, Patient Readmission, Risk Factors, Shock, Cardiogenic, Sleep Apnea, Obstructive, Survival Rate, United States
Abstract

Although several risk calculators are available to determine risk for readmission following a heart failure (HF) hospitalization, none provide information on cause-specific readmission. Understanding risk for cause-specific readmission could aid in developing a targeted approach to reducing readmissions. We sought to determine if a simple cardiac co-morbidity count could identify individuals at high risk for a cardiovascular (CV) readmission following a HF hospitalization. Using the Nationwide Readmissions Database, we examined nonfatal hospital discharges with a principal diagnosis of HF. We calculated a 0 to 3 cardiac co-morbidity count based on the presence of coronary artery disease, atrial arrhythmia, and/or ventricular arrhythmia. We used a multinomial logistic regression to determine if the cardiac co-morbidity count was independently associated with CV readmission or non-CV readmission, adjusting for patient- and hospital-level confounders. In 380,075 discharges, 28% had a co-morbidity count of 0, 47% had a count of 1, 23% had a count of 2, and 2% had a count of 3. In a fully adjusted model, cardiac co-morbidity count was independently associated with CV readmission: compared with individuals with a count of 0, the relative risk for those with a count of 1 was 1.27 (95% confidence interval [CI]: 1.23 to 1.31); for those with a count of 2 was 1.40 (95% CI: 1.35 to 1.46); and for those with a count of 3 was 1.36 (95% CI: 1.23 to 1.51). Cardiac co-morbidity count was not independently associated with non-CV readmission. In conclusion, we found that a simple cardiac co-morbidity count was independently associated with increased risk of CV but not non-CV readmission.

DOI10.1016/j.amjcard.2020.02.018
Alternate JournalAm J Cardiol
PubMed ID32245637
PubMed Central IDPMC8819501
Grant ListR03 AG056446 / AG / NIA NIH HHS / United States