Abstract 11676: Do Heart Failure Admission Rates Change Around Holidays? The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Heart failure (HF) exacerbations are often precipitated by dietary noncompliance, which is common around holidays. We examined whether HF hospitalizations would increase after major national holidays. Methods: The ARIC Study performed surveillance of HF admissions among patients age ≥55 years in 4 US communities from 2005-2014. HF admissions were identified by ICD-9 codes and validated by physician review. For each holiday (H), 4 days before the holiday (H-4 to H-1), and 4 days after the holiday (H+1 to H+4), we compared average daily HF admission rates, hospital length of stay (LOS), 28-day mortality, and 1-year mortality to the remaining days in each holiday’s month using Poisson regression using a complex sampling design. Results: ARIC identified 92,354 HF admissions (weighted). Patients admitted in holiday months were 46% male and 71% white, with average age 75 years. Compared to the holiday months, patients admitted on H were older (78 years, p<0.01). Race, community, and HF by ejection fraction were similar among time periods. Average daily admissions around each holiday are shown in Figure 1. For all holidays combined, average daily admissions compared to the remainder of the holiday months (25.1 per day) were less frequent on both H-1 (18.5, p=0.002) and H-1/H combined (19.5, p=0.005). Hospital LOS was shorter for patients admitted on H for Thanksgiving (5.3 v 6.9 days, p=0.02) and Christmas (4.8 v 7.5, p=0.01), on H-1 for Christmas (5.3 v 7.5, p=0.04) and during H-4 to H-2 for New Year’s Day (6.7 v 8.7, p=0.02). 28-day mortality was lower for patients admitted on H-1 (p<0.001) for Christmas. 1-year mortality was similar for all holidays and time periods. Conclusions: HF admission rates, hospital LOS, and mortality were similar in the 4 days following a holiday compared to the remainder of each holiday’s month. However, the day before and/or day of a holiday were associated with lower HF admission rates, shorter hospital LOS, and lower 28-day mortality.