Excessive Daytime Sleepiness and Sleep Disordered Breathing in Stable Heart Failure Patients

Abstract

considered preventable. Readmission monitoring is a key performance indicator for Heart Failure Management Programmes (HF-MPs). Aim: To investigate the underlying causes, contributing factors and incidence of unplanned hospital readmissions for HF patients. Methods:A sixmonth prospective studywas performed at the PrincessAlexandraHospital, a tertiary referral facility. A convenience sample of 50 adult patientsmanaged by theHF-MPwas recruited.Health literacywas assessed.All unplanned admissions were investigated with admission interview andworksheet. At six months hospital readmissions were verified by patients, patient medical records and electronic databases. Results: Participants mean age was 70 (±11.6), 38 (76%) were male, 11 (22%) had inadequate health literacy. Of the 45 (90%) patients with systolic HF, 35 (78%) had an ejection fraction (EF)≤ 30%. There were 46 unplanned readmissions during six month follow-up, 28 were HF related and involved 17 patients (HF readmissions 34%). Six of these patients had >1 readmission and six (12%) patients died. Of the patients readmitted for HF, 82% had systolic HF with EF≤ 30%, and an average length of stay of seven (±5.7) days. Thirty days readmission rate was 12%. Eighty-six percent of patients readmitted with HF were on optimal medical therapy including beta blocker, ACE inhibitor/Angiotensin II receptor antagonist and mineralocorticoid receptor antagonist. All patients received self-care education and early follow-up from multi-disciplinary HF clinicians. Conclusion:Unplanned HF readmissions in this cohort of patients with severe systolic HF are common despite optimal medical therapy and intensive HF-MPs. http://dx.doi.org/10.1016/j.hlc.2013.05.182