15-Year Trends in Patients Hospitalised With Heart Failure and Enrolled in an Australian Heart Failure Management Program

Wang, Nelson; Hales, S.; Tofler, Geoffrey H.

doi:10.1016/j.hlc.2018.10.010

Cited by 10 publications

(9 citation statements)

References 43 publications

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“…In fact, a study examining a 15-year trend among patients hospitalized for HF found that worsening dyspnea is the most common symptom among these patients, affecting 93% of them. 26 In contrast, a study on outpatients with HF in a cardiology clinic and palliative care center reported a pain rate of 84.4%, 27 which differed from the present results on inpatients with HF. This is because dyspnea is a major health problem affecting patients hospitalized for HF.…”

Section: Discussioncontrasting

confidence: 99%

Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records

Baik¹,

Ryu²,

Lee³

et al. 2021

CIN: Computers, Informatics, Nursing

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We examined the association between symptoms (ie, dyspnea and pain) and patient outcomes (ie, length of stay, 30-day readmission, and death in hospital) among patients with heart failure using EMRs. This was a descriptive study that was conducted from July 1, 2014, to November 30, 2017. Participants were 754 hospitalized patients with heart failure (mean age, 70.62 ± 14.78 years; male-to-female ratio, 1:1.1). Data were analyzed using descriptive statistics, χ 2 tests, and logistic regression analyses. Patients' average length of stay was 8.92 ± 13.12 days. Thirty-two patients (4.2%) were readmitted, and 100 patients (13.3%) died during hospitalization. Two-thirds (67.7%) experienced dyspnea, and 367 (48.7%) experienced pain. Symptoms and ICU admission were significantly related to patient outcomes. In the regression analyses, dyspnea, pain, and ICU admission were significantly related to higher-than-average lengths of stay. Dyspnea and ICU admission were related to death in hospital. Information regarding patients' symptoms, which was extracted from records, was a valuable resource in examining the relationship between symptoms and patient outcomes. The use of EMRs may be more advantageous than self-reported surveys when examining patients' symptom and utilizing big data.

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Section: Discussioncontrasting

confidence: 99%

Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records

Baik¹,

Ryu²,

Lee³

et al. 2021

CIN: Computers, Informatics, Nursing

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“…The 30-day readmission rate in the US is significantly higher at 16.7% compared to 9.9% from a similar population-based study in Australia. 11) However, this is consistent with rates of HF readmission rate in the US, which was at 18.2% based on the national readmission database. 12) Our study showed a similar rate of readmission in patients with HF with underlying AF.…”

Section: Discussionsupporting

confidence: 79%

In-Hospital Mortality Rate and Predictors of 30-Day Readmission in Patients With Heart Failure Exacerbation and Atrial Fibrillation: A Cross-Sectional Study

et al. 2022

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Background and Objectives Heart failure (HF) and atrial fibrillation (AF) are considered new cardiovascular epidemics of the last decade. Recent national trends show an uptrend in HF hospitalizations. We aimed to identify the 30-day readmission rate, causes, and impact on healthcare utilization in HF exacerbation with a history of AF. Methods We utilized 2018 Nationwide readmission data and included patients aged ≥18 years with International Classification of Diseases, Tenth Revision, Clinical Modification code indicating HF exacerbation and AF were included in the study. Primary outcome is 30-day readmission rates. Secondary outcomes were mortality rates, common causes of readmission, and healthcare utilization. Independent predictors for readmission were identified using cox regression analysis. Results The total number of admissions in our study was 48,250. The mean age was 77.8 years (standard deviation, 12.1), and 47.74% were females. The 30-day readmission rate was 16.72%. The mortality rate at index admission and readmission was 7.28% and 8.12%, respectively. The most common cause of readmission was the hypertensive heart and kidney disease with HF. The independent predictors of readmission were low socio-economic class, Medicaid, Charlson comorbidities score. The financial burden on healthcare for all the readmission was $461 million for the year 2018. Conclusions The 30-day readmission rate was 16.72%. The mortality rate increased from 7.28% to 8.12% with readmission. The financial burden for readmission during that year was $461 million. Future studies directed with interventions to prevents readmissions are warranted.

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“…Hospital readmissions are a recurrent and common event in the first 90 days after an ADHF index hospitalization despite persistent efforts to develop effective strategies to thwart this phenomenon worldwide. 1 , 2 , 3 The reason for this continuous burden is certainly multifactorial but involves the complex interplay of masked and/or unresolved clinical congestion coupled with poor adherence to self‐care and poor knowledge on the syndrome and its treatment. This disturbing situation seems to be particularly prevalent in low‐income and middle‐income countries.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent international surveys demonstrate that recurrent hospitalizations have not substantially decreased in the last decade. 2 , 3 In the United States, the mandatory federal ‘Hospital Readmissions Reduction Program’ created financial penalties for hospitals with higher readmission rates, but failed to achieve its objectives, leading to a small reduction in recurrent hospitalizations that was offset by an unintended increase in 30 day and 1 year mortality. 4 , 5 In this scenario, a solid body of evidence suggests that preventable and/or treatable precipitating factors are associated with acute decompensated HF (ADHF) hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

“…Readmissions after an index HF hospitalization are a major contemporary health problem, and programmes that effectively reduce rates of early clinical events are a global unmet need. Several recent international surveys demonstrate that recurrent hospitalizations have not substantially decreased in the last decade 2,3 . In the United States, the mandatory federal ‘Hospital Readmissions Reduction Program’ created financial penalties for hospitals with higher readmission rates, but failed to achieve its objectives, leading to a small reduction in recurrent hospitalizations that was offset by an unintended increase in 30 day and 1 year mortality 4,5 .…”

Section: Introductionmentioning

confidence: 99%

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Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission

Rohde

Filho²,

Rover

et al. 2021

ESC Heart Failure

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AimsTo evaluate a telemonitoring strategy based on automated text messaging and telephone support after heart failure (HF) hospitalization. Methods and resultsThe MESSAGE-HF study is a prospective multicentre, randomized, nationwide trial enrolling patients from 30 clinics in all regions of Brazil. HF patients with reduced left ventricular ejection fraction (<40%) and access to mobile phones are eligible after an acute decompensated HF hospitalization. Patients meeting eligibility criteria undergo an initial feasibility text messaging assessment and are randomized to usual care or telemonitoring intervention. All patients receive a HF booklet with basic information and recommendations about self-care. Patients in the intervention group receive four daily short text messages (educational and feedback) during the first 30 days of the protocol to optimize self-care; the feedback text messages from patients could trigger diuretic adjustments or a telephone call from the healthcare team. After 30 days, the frequency of text messages can be adjusted. Patients are followed up after 30, 90, and 180 days, with final status ascertained at 365 days by telephone. Our primary endpoint is the change in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels after 180 days. Secondary endpoints include changes in NT-proBNP after 30 days; health-related quality of life, HF self-care, and knowledge scales after 30 and 180 days; and a composite outcome of HF hospitalization and cardiovascular death, adjudicated by a blinded and independent committee. Conclusions The MESSAGE-HF trial is evaluating an educational and self-care promotion strategy involving a simple, intensive, and tailored telemonitoring system. If proven effective, it could be applied to a broader population worldwide.

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15-Year Trends in Patients Hospitalised With Heart Failure and Enrolled in an Australian Heart Failure Management Program

Cited by 10 publications

References 43 publications

Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records

Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records

In-Hospital Mortality Rate and Predictors of 30-Day Readmission in Patients With Heart Failure Exacerbation and Atrial Fibrillation: A Cross-Sectional Study

Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission

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