Abstract 17404: Heart Failure Hospitalization Readmissions and Mortality on Cardiology versus Non-Cardiology Services in a U.S. Hospital System

Abstract

Introduction: With the number of patients diagnosed with heart failure (HF) in the U.S. exceeding the number of cardiologists specialized to care for them, there is increasing reliance on non-cardiologists for treatment of acute decompensated heart failure (ADHF). Based on prior studies, there is concern that outcomes may be inferior under this circumstance. Hypothesis: Patients admitted with ADHF have lower 30-day readmissions when admitted to cardiology versus non-cardiology services. Methods: This was an observational, retrospective cohort study of 6885 patients with a primary diagnosis of ADHF based on ICD diagnosis-codes from 2015 to 2020. Data were retrieved from an EPIC-based registry with patients admitted to any of five network hospitals in a single health system. The registries were constructed through Clarity. Logistic regression adjusted for age, race, and gender was employed to distinguish differences in 30-day readmissions in those admitted with ADHF to cardiology vs. non-cardiology services. Results: Of the 6885 patients, 14% were admitted to cardiology, and 86% under non-cardiology services. The total cohort’s mean age was 69 (±15). The majority were White (71%) and male (54%). There was a statistically significant difference in mean age between cardiology services (68 [±14]) and non-cardiology services (69 [±15]) (p= 0.013). Black patients represented 15% of patients on cardiology services and 28% on non-cardiology services (p <0.0001). There were more male patients on the cardiology services (64%) than the non-cardiology services (52%) (p <0.0001). Unadjusted 30-day readmissions were lower for those admitted to cardiology vs. non-cardiology services (odds ratio 0.82 [95%CI: 0.67, 0.99, p=0.041]). Adjusted 30-day readmissions for those admitted to cardiology vs non-cardiology services were also lower (odds ratio 0.79 [95%CI: 0.65, 0.97, p=0.022). Conclusion: In this institutional electronic health record-based study, 30-day HF readmissions were found to be significantly lower in those admitted to cardiology vs. non-cardiology services. A future study to explore the variables contributing to these outcomes and to validate this data in a larger population is required.