Abstract 254: Gender and Race Specific Re-Admission Characteristics in Heart Failure Patients: Insights from the Get With The Guidelines Cohort

Abstract

Hypothesis: We investigated gender and race specific re-admission characteristics in heart failure patients enrolled in the Get With The Guidelines (GWTG) study. Material and Methods: Retrospective chart review of 49 GWTG cohort patients (15 females, 24 males) requiring readmission was performed. Demographic and clinical parameters were collected. Interval change in endpoints was classified as “Increase”, “Decrease”, or “No change”. Analysis of variance (ANOVA) and chi-square analyses were performed. Study was approved by the institutional IRB. Results: Amongst readmitted patients there was a trend for females to be older (73+/-14 vs. 66+/-15 years in males, p=0.208), more likely to have CAD (11 of 15 vs. 14 of 24 males, p=0.342), less likely reside at home (9 of 15 vs. 19 of 24 males, p=0.196), and have shorter time to readmission (16+/-14 vs. 20+/-14 days in males, p=0.435). There were no gender-specific differences in doses of beta-blockers, vasodilators, including ACE inhibitors-ARBs or Hydralazine/Nitrate combination, aldosterone receptor antagonists, or digoxin. However, re-admitted women were less likely to be on diuretics (6 of 15 vs. 1 of 24 males, p=0.029). There was a trend for males to be more likely readmitted with a decrease in systolic (7 of 16 vs. 2 of 10 females, p=0.216) or diastolic (5 of 16 vs. 2 of 10, p=0.258) blood pressure and have an increased heart rate (11 of 16 vs. 5 of 10 females, p=0.263). Predictably, majority of patients were noted to have an increased BNP (8 of 9 females vs. 10 of 15 males, p=0.224) and rise in creatinine (8 of 13 females vs. 14 of 24 males, p=0.982) or potassium (8 of 13 females vs. 16 of 24 males, p=0.298). Race had no effect on readmission (Caucasian females 7 of 12 vs. 12 of 18 males, p=0.643). Conclusion: Gender-specific differences in re-admission characteristics may be present in heart failure patients as suggested by observed trends in readmission timing, place of residence, and hemodynamic parameters, and significant difference in diuretic dosing. Race does not appear to affect readmission in the studied population. More studies of this important subject are required.