Abstract 16744: Impact of Wireless Pulmonary Artery Pressure Monitoring on Heart Failure Hospitalizations and All-Cause 30-Day Readmissions in Medicare-Eligible Patients With NYHA Class III Heart Failure: Results From the CHAMPION Trial

Abstract

Introduction: Heart failure (HF) is the most frequent discharge diagnosis for hospitalized Medicare beneficiaries. Readmission after a HF hospitalization (HFH) is an important metric for quality of care. Under the Hospital Readmissions Reduction Program (HRRP), hospitals with excess all-cause 30-day readmissions may be penalized for inadequate quality of care. Results from the CHAMPION trial confirmed that HF management using pulmonary artery pressure (PAP) monitoring from an implanted sensor in patients with NYHA Class III HF reduced HFH rates compared to standard management. However, the impact of this strategy on HFH rates and all-cause 30-day readmissions in Medicare-eligible patients is unknown. Methods: Retrospective analyses of patients 65 years or older at baseline in the CHAMPION trial were performed. HFH rates and 30-day readmissions in this subgroup were compared. Excess readmission ratios reported by the HRRP were then compared with the CHAMPION readmission ratio resulting from PAP monitoring. Results: 245 patients in CHAMPION (45%) were 65 years or older at the time of PA sensor implantation (120 in the Treatment group and 125 in the Control group). Patients in the Treatment group managed with PAP monitoring had a significantly lower HFH rate (60 HFH, 0.34/year) compared to the Control group (117 HFH, 0.67/year) (IRR 0.51, 95% CI 0.37-0.70, p<0.0001). The Treatment group had a significantly reduced 30-day readmissions rate (13 readmissions, 0.07/year) compared to the Control group (31 readmissions, 0.18/year) (IRR 0.42, 95% CI 0.20-0.82, p=0.006). Using index HFH as the unit of observation for 30-day readmissions, the Treatment group ratio (13 readmissions/56 index HFH, 23.2%) was lower than the Control group ratio (31 readmissions/99 index HFH, 31.3%). PAP monitoring resulted in a CHAMPION readmission ratio (23.2%/31.3%, 0.74) that was lower than all hospital excess readmission ratios reported in the 2011 HRRP dataset. Conclusions: HF management incorporating PAP monitoring significantly reduced HFH rates and all cause 30-day readmissions in Medicare-eligible patients. Adoption of this treatment strategy at hospitals struggling with HFH and 30-day readmissions could help address an unmet need within the US health care system.