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Readmission rate chf

Parag Goyal, Madeline R Sterling, Ashley N Beecy, John T Ruffino, Sonal S Mehta, Erica C Jones, Mark S Lachs, Evelyn M Horn
OBJECTIVES: Although postdischarge outpatient follow-up appointments after a hospitalization for heart failure represent a potentially effective strategy to prevent heart failure readmissions, patterns of scheduled follow-up appointments upon discharge are poorly described. We aimed to characterize real-world patterns of scheduled follow-up appointments among adult patients with heart failure upon hospital discharge. PATIENTS AND METHODS: This was a retrospective cohort study performed at a large urban academic center in the United States among adults hospitalized with a principal diagnosis of congestive heart failure between January 1, 2013, and December 31, 2014...
2016: Clinical Interventions in Aging
Amy Richardson, Elizabeth Tolley, Jonathan Hartmann, Jasmine Reedus, Brandi Bowlin, Christopher Finch, Christopher W Sands, Timothy Self
INTRODUCTION: Approximately 1 in 5 hospitalized COPD patients are readmitted within 30 days of discharge. CHF coexists in more than 20% of patients with COPD, and is associated with early readmission for COPD. Reducing 30-day hospital readmissions for COPD is of intense current interest. METHODOLOGY: A retrospective chart review was performed to identify patients discharged with COPD exacerbation and HFrEF. The primary objective was to evaluate if discharge medication prescribing following guidelines for both COPD and HFrEF correlates with reduced 30-day readmission rates...
October 2016: Respiratory Medicine
Lior Turgeman, Jerrold H May
OBJECTIVE: A hospital readmission is defined as an admission to a hospital within a certain time frame, typically thirty days, following a previous discharge, either to the same or to a different hospital. Because most patients are not readmitted, the readmission classification problem is highly imbalanced. MATERIALS AND METHODS: We developed a hospital readmission predictive model, which enables controlling the tradeoff between reasoning transparency and predictive accuracy, by taking into account the unique characteristics of the learned database...
September 2016: Artificial Intelligence in Medicine
Ari M Cedars, Sara Burns, Eric L Novak, Amit P Amin
BACKGROUND: Readmission is responsible for a large proportion of inpatient care costs in adult congenital heart disease. There are, however, few data available to identify at-risk patients or to suggest strategies for intervention to prevent rehospitalization. METHODS AND RESULTS: We conducted an analysis of admissions in patients over the age of 18 years with a 3-digit International Classification of Diseases-Ninth Revision code of 745 to 747 from the State Inpatient Databases of Arkansas (2008-2010), California (2003-2012), Florida (2005-2012), Hawaii (2006-2010), Nebraska (2003-2011), and New York (2005-2012)...
September 2016: Circulation. Cardiovascular Quality and Outcomes
Teruhiko Imamura, Koichiro Kinugawa
Tolvaptan (TLV), an arginine vasopressin type 2 antagonist, has been shown to play a role in ameliorating symptomatic congestion and normalizing diluted hyponatremia in patients with congestive heart failure (HF). However, most evidence was derived from patients with HF with reduced ejection fraction (HFrEF), and the clinical efficacy of TLV in patients with HF with preserved ejection fraction (HFpEF) remains uncertain. In this study, we retrospectively enrolled 60 in-hospital patients with stage D HF, who had received TLV to treat symptomatic congestion at our institute between 2011 and 2013...
September 28, 2016: International Heart Journal
Hassan Alkhawam, Raef Madanieh, Mohammed El-Hunjul, Abed Madanieh, Umer Syed, Sumair Ahmad, Joseph J Lieber, Timothy J Vittorio
BACKGROUND: Cardiovascular morbidity and mortality in heart failure (HF) patients comprise a major health and economic burden, especially when readmission rate and length of stay (LOS) are considered. With increasing average life expectancy, HF prevalence continues to rise. Diseases such as diabetes mellitus, hypertension and ischemic heart disease continue to be the leading causes of HF. Current data suggest that HF is the most common cause for hospital admission in patients older than 65 years...
August 2016: American Journal of the Medical Sciences
William J Rubenstein, Christian A Pean, Alexis C Colvin
PURPOSE: To investigate the 30-day postoperative adverse event (AE) rates of adults 60 years or older after shoulder arthroscopy and identify risk factors for complications in this patient population. METHODS: Patients aged 60 or more who underwent shoulder arthroscopy were identified in the American College of Surgeons National Surgery Quality Improvement Program database from 2006 to 2013 using 12 Current Procedural Terminology codes related to shoulder arthroscopy...
August 2, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Tony S Ma, David Paniagua, Ali E Denktas, Hani Jneid, Biswajit Kar, Wenyaw Chan, Biykem Bozkurt
In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties...
September 15, 2016: American Journal of Cardiology
Luke D Kim, Lei Kou, Barbara J Messinger-Rapport, Michael B Rothberg
OBJECTIVES: To validate the HOSPITAL score for predicting 30-day all-cause readmission rates in a cohort of medical patients discharged to skilled nursing facilities (SNFs). DESIGN: Retrospective cohort. SETTING: Cleveland Clinic Main Campus. PARTICIPANTS: Cleveland Clinic Main Campus medicine services patients who were admitted between January 1, 2011, and December 31, 2012, and subsequently discharged to 110 SNFs within a 25-mile radius of the hospital...
September 1, 2016: Journal of the American Medical Directors Association
Paskariatne Probo Dewi Yamin, Sunu Budhi Raharjo, Vebiona Kartini Prima Putri, Nani Hersunarti
BACKGROUND: Hospital length of stay (LOS) is a key determinant of heart failure hospitalization costs. Longer LOS is associated with lower quality of care measures and higher rates of readmission and mortality. Right ventricular (RV) dysfunction predicted poor outcomes in patients with stable chronic heart failure (CHF), however, its prognostic value in the acute decompensated heart failure (ADHF) patients has not been sufficiently clarified. This study investigated the prognostic value of RV dysfunction in predicting longer LOS in ADHF patients...
2016: Cardiovascular Ultrasound
C Taron-Brocard, V Looten, B Fahlgren, E Charpentier, L Guillevin, A Barna
INTRODUCTION: The prevalence rate of congestive heart failure is approximately 2% in high-income countries. The aim of this study was to assess the overall benefit of ultrafiltration therapy in patients with acute or persistent congestive heart failure. METHODS: We conducted a health technology assessment following the EUnetHTA guidelines, with systematic literature review from bibliographic medical databases, independent experts and manufacturer interviews. RESULTS: Thirteen clinical trials and five meta-analyses were examined...
September 2016: Annales de Cardiologie et D'angéiologie
Bredy Pierre-Louis, Shareen Rodriques, Vanessa Gorospe, Achuta K Guddati, Wilbert S Aronow, Chul Ahn, Maurice Wright
INTRODUCTION: Congestive heart failure (CHF) is a common cause of hospital readmission. MATERIAL AND 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...
June 1, 2016: Archives of Medical Science: AMS
Laurent Billot, Kate Corcoran, Alina McDonald, Gawaine Powell-Davies, Anne-Marie Feyer
BACKGROUND: The New South Wales Health (NSW Health) Chronic Disease Management Program (CDMP) delivers interventions to adults at risk of hospitalisation for five target chronic conditions that respond well to ambulatory care: diabetes, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and coronary artery disease. The intervention consists of two main components: (1) care coordination across sectors (acute, ambulatory, and community care from both public and private sectors) and clinical specialties, facilitated by program care coordinators, and (2) health coaching including management of lifestyle risk factors and medications and self-management...
June 2016: PLoS Medicine
Yu-Chu Shen, Vivian Y Wu
BACKGROUND AND OBJECTIVE: The Affordable Care Act enacted significant Medicare payment reductions to providers, yet long-term effects of such major reductions on patient outcomes remain uncertain. Using the 1997 Balanced Budget Act (BBA) as an experiment, we compare long-run trends in 30-day readmission across hospitals with different amount of payment cuts. RESEARCH DESIGN, SUBJECTS, AND MEASURES: Using 100% Medicare claims between 1995 and 2011 and instrumental variable hospital fixed-effects regression models, we compared changes in 30-day readmission trends for 5 leading Medicare conditions between urban hospitals facing small, moderate, and large BBA payment reductions across 4 periods [1995-1997 (pre-BBA period), 1998-2000, 2001-2005, 2006-2001]...
September 2016: Medical Care
Hassan Alkhawam, Robert Sogomonian, Feras Zaiem, Neil Vyas, Mohammed El-Hunjul, JoshPaul Jolly, Ahmed Al-Khazraji, Amar Ashraf
Infective endocarditis (IE) is a severe illness associated with significant morbidity and mortality. The primary purpose of this study was to evaluate morbidity and mortality of IE in a hospital serving the most diverse area in New York City. An analysis of 209 patients admitted to the hospital from 2000 to 2012 who were found to have IE based on modified Duke criteria. Among the 209 patients with IE, 188 (88.8%) had native heart valves and 21 (11.2%) had prosthetic valves. Of the patients with native heart valves, 3...
August 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Yashwant Agrawal, Sidakpal Panaich, Sourabh Aggarwal, Frank Saltiel, Jagadeesh K Kalavakunta, Vishal Gupta
BACKGROUND: Acute myocardial infarction (AMI) is the most common cause of mortality in the USA as per the data released by the CDC. Short term hospital readmissions account for a significant portion of health care budget and much of the focus recently has been on reducing 30day readmission rate aimed to identify the demographics associated with readmissions from AMI and major causes of readmissions. METHODS: We queried the Nationwide Inpatient Sample which represents 20% of all the United States hospital data for our study...
July 1, 2016: International Journal of Cardiology
Jo-Ann Mary Moore
Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program...
January 2016: Home Health Care Services Quarterly
Caleb Ferguson, Sally C Inglis, Phillip J Newton, Sandy Middleton, Peter S Macdonald, Patricia M Davidson
BACKGROUND: Chronic heart failure (CHF) and atrial fibrillation (AF) are complex cardiogeriatric syndromes mediated by physical, psychological and social factors. Thromboprophylaxis is an important part of avoiding adverse events in these syndromes, particularly stroke. PURPOSE: This study sought to describe the clinical characteristics of a cohort of patients admitted to hospital with CHF and concomitant AF and to document the rate and type of thromboprophylaxis...
April 1, 2016: European Journal of Cardiovascular Nursing
Jacques D Donzé, Patrick E Beeler, David W Bates
OBJECTIVE: The study objective was to compare the 30-day readmission rate and mortality between patients with heart failure who have persistent hyponatremia during hospitalization and patients who have their admission hyponatremia corrected before discharge. METHODS: This large retrospective cohort study included all adult patients admitted with a diagnosis of congestive heart failure to a tertiary-care hospital between July 2003 and October 2009. We compared the readmission rate and mortality 30 days after discharge between patients with persistent hyponatremia (ie, low sodium level at both admission and discharge) and patients with hyponatremia correction during hospitalization...
August 2016: American Journal of Medicine
Brianna L Siracuse, Ronald S Chamberlain
IMPORTANCE: Total hip replacement is a commonly performed orthopedic procedure for the treatment of painful arthritis, osteonecrosis, or fracture. OBJECTIVE: To develop and verify a scale for predicting readmission rates for total hip replacement patients and allow for the development and implementation of readmission risk-reduction strategies. DESIGN, SETTING, AND PARTICIPANTS: Discharge data on 268 518 patients from New York and California (derivation cohort) and 153 560 patients from Florida and Washington (validation cohort) were collected from the State Inpatient Database, a part of the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality (2006-2011)...
August 1, 2016: JAMA Surgery
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