Cardiovascular Disease: Cardiovascular Disease |

Variations in Clinical Characteristics and Laboratory Results in Congestive Heart Failure: 30 Days Readmitted vs Not Readmitted FREE TO VIEW

Mena Yacoub, DO; Barry Shapiro, DO; Gus Slotman, MD
Author and Funding Information

Inspira Health Center, Vineland, NJ

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):71A. doi:10.1016/j.chest.2016.08.079
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SESSION TITLE: Cardiovascular Disease

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To identify clinical variations between CHF patients readmitted versus not re-admitted within 30 days of discharge.

METHODS: Data from 4,696 patients with a primary admission diagnosis of CHF were analyzed retrospectively in those re-admitted and not re-admitted. Laboratory results and clinical characteristics were then analyzed for differences between the two groups 48 and 96 hours prior to discharge.

RESULTS: An analysis of patient characteristics revealed no significant difference for weight, sex, race, history of angina, atrial fibrillation, and family history of CHF or COPD between readmitted and non readmitted. Patients who had a previous MI (22% vs 13%, p<0.0001), or diabetes (51% vs 46%, p=0.013) were significantly more likely to be readmitted. Patients with hypertension were less likely to be readmitted (29% vs 38%, p<0.0001). Patient weight was higher (186±63lbs vs 180±61lbs, p=0.0006) in those not re-admitted versus re-admitted. Emergency Department (ED) visits in the previous 12 months were increased in patients re-admitted (84.22% vs 74.28%, p<0.0001), as were total hospital admissions (76.01% vs 58.72, p<0.0001). At 96 hours and 48 hours before discharge, BUN, creatinine, serum osmolality, % neutrophils, WBC and anion gap were higher in re-admitted patients (P<.001 all). First 48 hours BUN/creatinine ratio was increased (20.0±10 vs 19.1±8.4, p=0.019) in readmitted patients; whereas first 48 hours of admission, 96 hours pre-discharge, and 48 hours pre-discharge, glomerular filtration rate and hemoglobin were reduced (p<0.0001 all).

CONCLUSIONS: CHF patients who were re-admitted within 30 days presented statistically significant variations in medical history, weight, and critical hospital laboratory values that separated them from patients not re-admitted. ED visits, MI history, diabetes, and hypertension were important factors. Renal function, systemic perfusion, and hematologic indicators varied significantly between re-admitted and not re-admitted patients. An attempt to achieve desired values may prove effective in reducing CHF patient re-admittance.

CLINICAL IMPLICATIONS: To reduce CHF re-admissions, certain laboratory results prior to discharge should be achieved. Elucidating and obtaining these laboratory results will prove to be beneficial to the patient as well as the hospital, while preserving resources.

DISCLOSURE: The following authors have nothing to disclose: Mena Yacoub, Barry Shapiro, Gus Slotman

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