Clinical factors associated with early readmission among acutely decompensated heart failure patients.
BACKGROUND
Congestive heart failure (CHF) is a common cause of hospital readmission.


METHODS
A retrospective study was conducted at Harlem Hospital in New York City. Data were collected for 685 consecutive adult patients admitted for decompensated CHF from March, 2009 to December, 2012. Variables including patient demographics, comorbidities, laboratory studies, and medical therapy were compared between CHF patient admissions resulting in early CHF readmission and not resulting in early CHF readmission.


RESULTS
Clinical factors found to be independently significant for early CHF readmission included chronic obstructive pulmonary disease (odds ratio (OR) = 6.4), HIV infection (OR = 3.4), African-American ethnicity (OR = 2.2), systolic heart failure (OR = 1.9), atrial fibrillation (OR = 2.3), renal disease with glomerular filtration rate < 30 ml/min (OR = 2.7), evidence of substance abuse (OR = 1.7), and absence of angiotensin-converting enzyme inhibitors or angiotensin receptor blocker therapy after discharge (OR = 1.8). The ORs were used to develop a scoring system regarding the risk for early readmission.


CONCLUSIONS
Identifying patients with clinical factors associated with early CHF readmission after an index hospitalization for CHF using the proposed scoring system would allow for an early CHF readmission risk stratification protocol to target particularly high-risk patients.
Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
Bredy
B
Pierre-Louis
St. Mary's Medical Center, Huntington, West Virginia, USA.
Shareen
S
Rodriques
Hartford Hospital, Harford, CT, USA.
Vanessa
V
Gorospe
SUNY Downstate Medical Center, Brooklyn, NY, USA.
Achuta K
AK
Guddati
Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
Wilbert S
WS
Aronow
Southwestern Medical Center, University of Texas, Dallas, TX, USA.
Chul
C
Ahn
Columbia University Medical Center, Harlem Hospital Center, New York, NY, USA.
Maurice
M
Wright
congestive heart failure; heart failure readmission; risk factors