Predictors of 30-day readmission in patients hospitalized with decompensated heart failure.
BACKGROUND
Heart failure (HF) is the leading cause of hospitalizations and readmissions in the United States. Approximately one-third of patients admitted for HF are readmitted within 3 months; however, there are few markers that can identify those at highest risk for readmission. The purpose of this study was to identify clinical and laboratory markers associated with hospital readmission in decompensated HF.


OBJECTIVE
Clinical and laboratory markers are associated with readmission rates in decompensated HF.


METHODS
Clinical and laboratory data from 412 patients admitted with HF were analyzed using a multivariable logistic regression analysis to find predictors of HF readmission by 30 days.


RESULTS
HF readmission rates at 30 days were lowest in those with at least 2 of the following discharge criteria: net fluid reduction >1.3 L (odds ratio [OR]: 0.27, P = 0.019), serum sodium level >135 (OR: 0.46, P = 0.034), and N-terminal brain natriuretic peptide level reduction >23% (OR: 0.11, P = 0.048). In multivariate analysis, those patients meeting ≥2 criteria had a very low risk of 30-day readmission (OR: 0.10, 95% confidence interval: 0.01-0.68, P = 0.019) compared to patients who failed to meet 2 criteria.


CONCLUSIONS
A negative fluid balance, normal serum sodium, and net reduction in N-terminal brain natriuretic peptide level during hospitalization may be important indices to target to help reduce the likelihood of HF readmission within 30 days.
Department of Internal Medicine, Cleveland Clinic Florida, Weston, Florida.
Marlow B
MB
Hernandez
Randall S
RS
Schwartz
Craig R
CR
Asher
Elsy V
EV
Navas
Victor
V
Totfalusi
Ivan
I
Buitrago
Ankush
A
Lahoti
Gian M
GM
Novaro
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D010359:Patient Readmission / Q000639:trends*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology