Factors Associated With 7-Day Rehospitalization After Heart Failure Admission. Issue 4 (July 2017)

• Record Type: Journal Article
• Authors: Eastwood, Cathy A.; Quan, Hude; Howlett, Jonathan G.; King-Shier, Kathryn M.
• Is Part Of: Journal of cardiovascular nursing. Volume 32:Issue 4(2017)
• Publication Date: 2017-07
• Subjects: case-control studies -- frail elderly -- heart failure -- hospital readmission; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Heart -- Diseases -- Nursing -- Periodicals; Heart -- Diseases -- Prevention -- Periodicals; 616.10231
• DOI: 10.1097/JCN.0000000000000347
• Languages: English
• ISSNs: 0889-4655

Abstract

Abstract : Background: Rehospitalizations within 7 days after discharge may reflect the quality of hospital care. Objective: We examined factors associated with 7-day readmissions after discharge for heart failure (HF). Methods: Using a matched pair case-control design, we examined health records for sociodemographic, clinical, and health system factors for patients with a primary diagnosis of HF (ICD-10 I50) discharged alive from all acute care hospitals in Calgary, Alberta, from 2004 to 2012. Logistic regression was used to identify variables associated with 7-day all-cause readmission. Results: We included 382 patients, or 191 in matched pairs, with 41% of readmissions due to HF. Frailty (adjusted odds ratio [aOR], 2.30; 95% confidence interval [CI], 1.41–3.76) and attending physician as specialist (aOR, 2.10; 95% CI, 1.32–3.42) were associated with increased likelihood of readmission. Reduced likelihood of readmission was associated with documented instructions for follow-up with a family physician within 1 week of discharge (aOR, 0.56; 95% CI, 0.36–0.88). All 3 factors were easily abstracted from all patient records, including frailty, which was defined as all 3 of age older than 75 years, 3 or more comorbid conditions, and requiring assistance with activities of daily living. Conclusion: Very early readmission to hospital after HF admission is associated with 3 factors that may be easily identified in patient records.