Abstract
Background: In the recent years, there has been a focus on decreasing heart failure readmission rates with many hospital initiatives directed towards implementation of heart failure discharge protocols. We hypothesize that identifying those patients at risk for readmissions may help prevent future readmissions. Methods: All patients with heart failure who presented to a tertiary urban medical center from July 2008 to December 2011 were included. Readmission was defined as being admitted to the hospital within one month of a previous heart failure admission. A multivariate analysis was performed on patients readmitted with goal to identify risk factors. Results: The study period had 3790 admissions for heart failure where 476 (12.7%) of which were readmissions. It was found that for every unit increase in body mass index (BMI) and hemoglobin, there was a significant decrease in odds of readmission. Antiarrhythmic medication, lipid medication, or angiotensin II receptor blockers (ARBs) also have a significant protective effect. Isosorbide, warfarin, cardiac resynchronization therapy (CRT), and for every unit increase in blood urea nitrogen (BUN) there was a significant increase in the patient’s risk of readmission (Table 1). Conclusions: Our single center, retrospective study shows an obesity paradox and a protective effect seen with heart failure medications as well as lipid lowering medications. This information may be used to target at risk patients in order to decrease readmission by establishing close follow-up and maximizing medical therapies.
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