Abstract P160: Contributing Factors to Prolonged Length of Hospital Stay After Readmission Among Patients With Cardiovascular Diseases in Rural Appalachia

Abstract

Introduction: The Appalachian region has a disproportionate rate of morbidity and mortality related to cardiovascular diseases (CVD), compared to other regions in the United States. Readmission after initial hospitalization for CVD is a major health and economic burden. However, little is known about the factors that contribute to a prolonged length of hospital stay (LOS) after readmission for CVD in rural Appalachia. This study aimed to identify factors associated with prolonged LOS after readmission of patients with CVD in rural Appalachian region. Hypothesis: It is hypothesized that certain demographic and CVD risk factors would be positively and significantly associated with prolonged LOS after readmission of patients with CVD. Methods: Study population consisted of 2,063 patients from Central Appalachia who were diagnosed with ≥1 CVD-related medical comorbidities (diabetes, hypertension, hypercholesterolemia, depressive symptoms, coronary artery disease, stroke, and heart failure) and readmitted between 2010 and 2016 to a large health system. The average LOS was assessed and the Cox Proportional Hazard Ratios (HR) were calculated to identify factors associated with prolonged LOS (defined as a LOS of six or more days) after readmission among CVD patients. The median LOS and probability of prolonged LOS for different sociodemographic risk groups in the study population were calculated. Results: The average LOS was 13.44±45.77 days. A one-year increase in the age of CVD patients tended to increase the risk of prolonged LOS by 0.6% (95% CI: 1.00-1.01; p=0.04). Additionally, being male was found to be associated with increased risk of prolonged LOS (HR: 1.20; 95% CI: 1.08-1.34; p<0.001). Similarly, having at least one CVD related comorbid condition increased the risk of prolonged LOS by 23.3% (95% CI: 1.03-1.47; p=0.02). Our findings also showed that both underweight and obese CVD patients were at 58.2% (95% CI: 0.52-0.65; p<0.0001) and 53.6% (95% CI: 0.50-0.56; p<0.0001) higher risk of having a prolonged LOS, respectively. Conclusions: In conclusion, increasing age, being male, having ≥1 comorbidities of CVD, and being underweight or obese were positively associated with prolonged LOS after hospital readmission in this rural population. These findings suggest that preventing and treating comorbid conditions and CVD risk factors may lower the likelihood of a prolonged LOS after readmission.