• Donald P McLaren, Roy Jones, Ronald Plotnik, Wojciech Zareba, Scott McIntosh, Jeffrey Alexis, Leway Chen, Robert Block, Charles J Lowenstein, and Valentina Kutyifa.
• University of Rochester Medical Center Rochester NY. valentina.kutyifa@heart.rochester.edu.
• Cardiol J. 2016 Jan 1; 23 (2): 155-62.

BackgroundHospital readmission is a significant health burden. More than 20% of heart failure (HF) patients are readmitted within 30 days of discharge leading to billions of dollars in health care expenditures. However, the role of prior hospital admissions to predict 30-day readmission for HF patients is not fully understood.MethodsWe retrospectively analyzed HF hospitalization data for 4 years at a single medical center. Association between prior admission and 30-day readmission after HF hospitalization was assessed using a multivariate logistic regression model.ResultsA total of 1,999 patients with index HF hospitalizations were identified, and 366 of them (18%) were readmitted within 30 days. The rate of readmission was 14%, 20%, and 33% in patients with 0, 1, ≥ 2 prior admissions. Patients with one prior admission had a 50% higher risk (confidence interval [CI] 1.10-2.05, p = 0.011) for readmission, while those with ≥ 2 prior admissions had a more than 3-fold increase in readmission (CI 2.27-4.09, p < 0.001), after adjustments for relevant clinical covariates. Prior hospital admission provided incremen-tal value in predicting readmissions, shown by the significant improvement in the readmission predictive model (C-statistics increased from 0.57 to 0.63). However, neither the length of stay nor recency of prior admission was a significant factor in predicting readmissions.ConclusionsHospital admission prior to an index HF hospitalization is associated with a significantly increased risk for 30-day hospital readmission and could be used to identify patients at high-risk for readmission and potentially target interventions to reduce the risk of readmission for these patients.

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