Predictors of thirty-day readmission in nonagenarians presenting with acute heart failure with preserved ejection fraction: a nationwide analysis
Ahmed Maraey1
Mahmoud Salem2
Nabila Dawoud3
Mahmoud Khalil4
Ahmed Elzanaty5
Hadeer Elsharnoby6
Ahmed Younes7
Ahmed Hashim8
Amit Alam9
1.Department of Internal Medicine,the CHI St.Alexius Health,Bismarck,USA;Department of Internal Medicine,University of North Dakota,Bismarck,USA2.Center for Advanced Heart and Lung Diseases,Baylor University Medical Center,Dallas,USA3.Department of Internal Medicine,University of Kentucky,Lexington,USA4.Department of Internal Medicine,Lincoln Medical Center Weil Cornell University,Bronx,USA;Department of Cardiovascular Medicine,Tanta University,Tanta,Egypt5.Department of Cardiovascular Disease,University of Toledo,Toledo,USA6.Faculty of Medicine,Tanta University,Tanta,Egypt7.Department of Internal Medicine,East Carolina University,Greenville,USA8.Faculty of Medicine,Ain Shams University,Cairo,Egypt9.Center for Advanced Heart and Lung Diseases,Baylor University Medical Center,Dallas,USA;College of Medicine,Texas A&M Health Science Center,Dallas,USA
摘要：BACKGROUD Acute heart failure with preserved ejection fraction (HFpEF) is a common but poorly studied cause of hospital admissions among nonagenarians. This study aimed to evaluate predictors of thirty-day readmission, in-hospital mortality, length of stay, and hospital charges in nonagenarians hospitalized with acute HFpEF. METHODS Patients hospitalized between January 2016 and December 2018 with a primary diagnosis of diastolic heart failure were identified using ICD-10 within the Nationwide Readmission Database. We excluded patients who died in index admission, and discharged in December each year to allow thirty-day follow-up. Univariate regression was performed on each variable. Vari-ables with P-value < 0.2 were included in the multivariate regression model. RESULTS From a total of 45,393 index admissions, 43,646 patients (96.2％) survived to discharge. A total of 7,437 patients (15.6％) had a thirty-day readmission. Mean cost of readmission was 43,265 United States dollars (USD) per patient. Significant predictors of thirty-day readmission were chronic kidney disease stage Ⅲ or higher [adjusted odds ratio (aOR) = 1.20, 95％ CI:1.07?1.34, P = 0.002] and diabetes mellitus (aOR = 1.18, 95％ CI: 1.07?1.29, P = 0.001). Meanwhile, female (aOR = 0.90, 95％ CI:0.82?0.99, P = 0.028) and palliative care encounter (aOR = 0.27, 95％ CI: 0.21?0.34, P < 0.001) were associated with lower odds of readmission. Cardiac arrhythmia (aOR = 1.46, 95％ CI: 1.11?1.93, P = 0.007) and aortic stenosis (aOR = 1.36, 95％ CI: 1.05?1.76, P =0.020) were amongst predictors of in-hospital mortality. CONCLUSIONS In nonagenarians hospitalized with acute HFpEF, thirty-day readmission is common and costly. Chronic co-morbidities predict poor outcomes. Further strategies need to be developed to improve the quality of care and prevent the poor outcome in nonagenarians.
机标关键词：fractionanalysisheartwithacuteejectionfailurenationwide
论文发表日期：2021-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 1008-1018 )