PO-712-03 RATE OF 30-DAY READMISSION AND ECONOMIC BURDEN IN PATIENTS WITH SICK SINUS SYNDROME WITH COEXISTING CHRONIC DIASTOLIC HEART FAILURE WHO UNDERWENT PACEMAKER INSERTION

Abstract

Patients with Chronic Diastolic Heart Failure (cDHF) have multiple risk factors & can develop conduction disturbances that necessitate pacemaker insertion (PMI). Heart failure outcomes after PMI are poorly understood. We sought to determine the 30-Day Readmission rate (30-DRr) & outcomes of patients with Sick Sinus Syndrome (SSS) with co-existing cDHF who underwent PMI. Using the 2017 & 2018 National Readmission Database, we conducted a retrospective analysis of patient discharges with SSS who underwent pacemaker insertion as a principal diagnosis and cDHF as a secondary diagnosis. Readmission was defined as the first admission to any hospital within 30 days of the index admission. Same-day admissions and discharges excluded. The primary outcome was 30DRr, while secondary outcomes were readmission mortality rate, most common diagnoses for readmission, and resource utilization defined by length of stay (average and total), patient charge (average and total), and total hospital cost (average and total). There was a total of 9,441 index hospitalization for SSS with coexisting cDHF who underwent pacemaker insertion &; the mean age was 79.7 yrs. & 62.9% of patients were females. In-hospital mortality rate for index admission was 1.05%, while 30-DRr was 10.8% (Figure 1). Among this group of readmitted patients, In-hospital mortality rate was 4.4%, compared to index admission(4.4% vs. 1.05%, adjusted p=0.004, OR; 3.4, CI; 1.5-7.8). The total hospital days associated with readmission were 5,368 days, with a total hospital cost of $12,100,000 & a total patient's economic burden of $49,100,000. Patients admitted for SSS with coexisting cDHF who underwent PMI showed a high readmission rate with increased mortality. In addition, coexisting chronic kidney disease (CKD), atrial fibrillation, chronic right ventricular pacing, valvular disease, cardiac amyloid, ischemic heart disease may contribute to a greater risk of DHF. Risk factor modification & SGLT2i may lower the risk of HF & readmission.