Title | Relation of a Simple Cardiac Co-Morbidity Count and Cardiovascular Readmission After a Heart Failure Hospitalization. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Visaria A, Balkan L, Pinheiro LC, Bryan J, Banerjee S, Sterling MR, Krishnan U, Horn EM, Safford MM, Goyal P |
Journal | Am J Cardiol |
Volume | 125 |
Issue | 10 |
Pagination | 1529-1535 |
Date Published | 2020 May 15 |
ISSN | 1879-1913 |
Keywords | Age 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. |
DOI | 10.1016/j.amjcard.2020.02.018 |
Alternate Journal | Am J Cardiol |
PubMed ID | 32245637 |
PubMed Central ID | PMC8819501 |
Grant List | R03 AG056446 / AG / NIA NIH HHS / United States |