title: Comparison of Length of Stay, 30-Day Mortality, and 30-Day Readmission Rates in Medicare Patients With Heart Failure and With Reduced Versus Preserved Ejection Fraction.
abstract: Length of stay (LOS), 30-day mortality, and 30-day readmission rates have not been compared between Medicare beneficiaries with heart failure (HF) with reduced ejection fraction (HFrEF) and beneficiaries with heart failure with preserved ejection fraction (HFpEF), although HFpEF is common in patients with HF. To determine whether type of HF (HFrEF or HFpEF) was associated with LOS, 30-day mortality, and 30-day readmission, we used a cohort of 19,477 Medicare beneficiaries admitted to the hospital and discharged alive with a primary discharge diagnosis of HF between 2007 and 2011. Gamma regression, Poisson regression, and Cox proportional hazards with a competing risk for death were used to model LOS, 30-day mortality, and 30-day readmission rate, respectively. All models were adjusted for HF severity, co-morbidities, demographics, nursing home residence, and calendar year of admission. Beneficiaries with HFpEF had an LOS 0.02 days shorter than beneficiaries with HFrEF and a nearly identical 30-day readmission rate. Thirty-day mortality was 10% lower in beneficiaries with HFpEF versus HFrEF. In conclusion, readmission rates were as high in those with HFpEF as they are in those with HFrEF, with comparable LOS in the hospital.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: loop2@uab.edu.
authors.forename: Matthew Shane
authors.initials: MS
authors.lastname: Loop
authors.affiliation: Center for Observational Research, Amgen Inc., Thousand Oaks, California.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Van Dyke
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Ligong
authors.initials: L
authors.lastname: Chen
authors.affiliation: Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Brown
authors.affiliation: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Raegan W
authors.initials: RW
authors.lastname: Durant
authors.affiliation: Division of General Internal Medicine, Weill Department of Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D006278:Medicare; D010359:Patient Readmission; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D014481:United States