Abstract 12927: Concurrent Pneumonia has no Association With 30-Day All-Cause or Heart Failure Readmissions but is Associated With Higher 30-Day Pneumonia Readmission and MayBe Associated With Higher 30-Day All-Cause Mortality in Older Medicare Beneficiaries Hospitalized for Heart Failure

Abstract

Background: Pneumonia (20%) is the second leading cause for 30-day all-cause readmission after heart failure (HF; 27%). However, little is known about the impact of pneumonia during index HF hospitalization on 30-day all-cause readmission. Methods: Of the 8049 Medicare beneficiaries hospitalized for decompensated HF (72% with known HF) discharged alive from 106 U.S. hospitals (1998-2001), 2048 (25%) had pneumonia (1670 on admission and 378 in-hospital). Using propensity scores for pneumonia, we assembled a matched cohort of 1982 pairs of patients balanced on 33 baseline characteristics. Results: 30-day all-cause readmissions occurred in 899 (23%) of matched patients and there was no difference between those with and without pneumonia (HR, 1.00; 95% CI, 0.88-1.15; p=0.947; Fig, left). 30-day pneumonia readmission occurred in 41 matched patients which was higher among those with pneumonia (HR, 1.96; 95% CI, 1.03-3.74; p=0.041). 30-day HF readmission occurred in 342 patients but had no association with pneumonia (HR, 1.10; 95% CI, 0.89-1.36; p=0.365). 30-day all-cause death occurred in 303 patients, which was higher among those with pneumonia (9% vs 7%; HR, 1.26; 95% CI, 1.00-1.58; p=0.046; Fig, right). These associations persisted throughout 12 months post-discharge. Conclusions: Among patients with HF, on-admission or in-hospital pneumonia during index hospital admission is associated with significantly higher 30-day death and pneumonia readmissions but not with 30-day all-cause or HF readmissions