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Variables that increase heart failure patients' risk of early readmission: a retrospective analysis

Bartone, Cheryl L.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377869498

Abstract Details

2013, MS, University of Cincinnati, Medicine: Epidemiology (Environmental Health).
Background: Accurate risk assessment of early hospital readmission after an index heart failure admission is important clinical information for both physicians and patients. Methods: An electronic health records search from The Christ Hospital in Cincinnati, Ohio from January 2008 through December 2011 reveals 3,581 patients discharged with a primary diagnosis of acute decompensated heart failure. The data were analyzed using multivariate logistic regression, and the results were used to develop a prediction tool in order to identify patients at high risk for an early readmission. Results: The twelve variables found to be associated with an increased risk of early readmission were hyponatremia, gender, number of documented diagnoses, length of stay, admitting service, estimated income, beta-blocker prescribed upon discharge, loop diuretic prescribed upon discharge, renal dysfunction, chronic obstructive pulmonary disease, cerebrovascular disease, and diabetes mellitus. Of these, admitting service [other than cardiology], hyponatremia, and renal dysfunction were the most predictive of an early hospital readmission, with respective p-values of <0.0001, 0.0001, and 0.0004. A predictive risk scoring system was developed based on this model. A very high predictive risk for readmission was associated with an observed readmission rate of 29%, whereas the low risk group had a 5.6% observed readmission rate (chi-square p-value=5.0e-11). Conclusion: This study provides a useful model for predicting early readmission in recently discharged patients at The Christ Hospital, namely patients admitted by physicians other than cardiologists, those with hyponatremia, and those who have renal dysfunction. Intervention strategies should be developed in order to target the high risk patients, thereby reducing readmissions and likely improving outcomes.
Erin Nicole Haynes, Dr.P.H. (Committee Chair)
Eugene Chung, Ph.D. (Committee Member)
Paul Succop, Ph.D. (Committee Member)
21 p.
Surgery
heart failure; readmission; predict

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Citations

  • Bartone, C. L. (2013). Variables that increase heart failure patients' risk of early readmission: a retrospective analysis [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377869498

    APA Style (7th edition)

  • Bartone, Cheryl. Variables that increase heart failure patients' risk of early readmission: a retrospective analysis. 2013. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377869498.

    MLA Style (8th edition)

  • Bartone, Cheryl. "Variables that increase heart failure patients' risk of early readmission: a retrospective analysis." Master's thesis, University of Cincinnati, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377869498

    Chicago Manual of Style (17th edition)

ucin1377869498
355
© 2013, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.