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

Abstract

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.

Development and validation of a prediction model for in-hospital death in patients with heart failure and atrial fibrillation

“…There was evidence indicated that antiarrhythmic [ 28 , 29 ], beta-blockers [ 30 , 31 ], and anticoagulation [ 32 ] were correlated with the prognosis of patients with HF or patients with HF and AF. Charlson comorbidity index, the most extensively studied comorbidity index, was found to be associated with the clinical outcome in patients with HF [ 33 ] and an important predictor for 30-day readmission in patients with HF exacerbation and AF [ 34 ]. Age and creatinine were also demonstrated to have predictive value for in-hospital mortality in patients with cardiogenic shock [ 25 ].…”

What Is the Right Direction for the IJHF and Editorial Board?

“…Besides invited review articles and guidelines, many research papers and review articles with various quality are submitted around the globe. Encouragingly, certain important papers published in IJHF have been highly cited, 2 3 4) which has been very pleasing to our contributing researchers. The accountability for and transparency in the quality of all published content lies with the editorial board of the IJHF .…”

The effects on rehospitalization rate of transitional care using information communication technology in patients with heart failure: A scoping review

“…Furthermore, patients with heart failure are known to have a chronic course and a high rehospitalization rate. In the United States (U.S.), approximately 5 million patients have heart failure, and the readmission rate within 30 days of discharge is reported to be as high as 25% ( Heidenreich et al., 2013 ); furthermore, in 2018, the 30-day readmission rate was 16.7% ( Gangu et al., 2022 ). In China, the readmission rate within one month of discharge was the same ( Li, 2017 ).…”