Abstract P245: Increased Hospital Length of Stay as a Predictor of Heart Failure Readmission

Abstract

Background: Heart Failure (HF) is a major cause of morbidity and mortality with a global prevalence estimated at 16 million. Understanding the risk factors and predictors assists in identifying patients at high risk of subsequent re-hospitalization and death. Consequently, we hypothesized that hospital Length of Stay (LOS) can predict the risk of HF patients’ readmission within a year from an indexed HF hospitalization. Methods: A total of 1,255 HF patients admitted to a VA medical center between January 2004 and December 2009, were identified with IDC-9 code for HF. In order to reduce selection bias, patients were required to have at least on HF readmission from the index HF hospitalization. LOS was categorized in two groups (less than 7 days and more than 7days). The study sample was analyzed using Kaplan Meier (KM) estimate and Cox proportional hazard regression in order to assess the risk of patients’ readmission within a year from their indexed HF hospitalization at a significance level of 0.05. Results: Among the HF patients identified, 511 met the inclusion criteria. The KM curves below show that patients with LOS greater than 7days are more likely to be readmitted compared to those with LOS less than 7 days. Cox proportional hazard regression confirmed this finding with a hazard ratio of 1.39 (CI: 1.08 – 1.79) and a p-value = 0.012 while adjusting for age, tobacco use, diabetes and medications at first HF discharge. Conclusion: From this study sample, we can predict that patients with LOS greater than 7 days are 1.39 times more likely to be readmitted within a year compared to those with LOS less than 7 days.