Statistical Models and Patient Predictors of Readmission for Heart Failure<subtitle>A Systematic Review</subtitle>

Abstract

Background: Readmission after heart failure (HF) hospitalization is an increasing focus for physicians and policy makers, but statistical models are needed to assess patient risk and to compare hospital performance. We performed a systematic review to describe models designed to compare hospital rates of readmission or to predict patients' risk of readmission, as well as to identify studies evaluating patient characteristics associated with hospital readmission, all among patients admitted for HF.

Serum Neprilysin and Recurrent Admissions in Patients With Heart Failure

“…These results replicate our previous findings10, 11, 12 and provide further evidence regarding the utility of this biomarker in the prediction of recurrent hospitalizations, an end point of clinical significance that currently cannot be predicted accurately with standard prognostic factors 3, 4…”

Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

“…Among the 304 readmissions, the median (IQR) time to readmission was 11 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) days. The most common readmission diagnoses by CCS Level 3 category were congestive heart failure, pneumonia, coronary atherosclerosis without acute myocardial infarction, cardiac dysrhythmias, and obstructive chronic bronchitis, which together accounted for 25 % of readmissions.…”

“…Among all hospitalized Medicare beneficiaries (including community-dwelling and institutionalized elders, as well as younger disabled Medicare beneficiaries), nearly one in five were readmitted within 30 days, and over one-third were readmitted within 90 days. 1 These readmitted individuals have been described in some detail; research has identified early readmission risk factors for general 2,3 and geriatric populations, [4][5][6] as well as those with specific diseases such as heart failure, 7 stroke, 8 and chronic obstructive pulmonary disease. 9 Individuals readmitted early are more likely to have multiple medical comorbidities, greater length of stay during the index hospitalization, and additional recent hospitalizations.…”

Impact of Social Factors on Risk of Readmission or Mortality in Pneumonia and Heart Failure: Systematic Review

“…17 Data abstracted from each publication included: funding source, purpose, design, time period, data source, method of identifying cases, number of hospitals, hospital geographic location, statistical strategy, sample size, follow-up period, type of readmission or mortality (all-cause or disease specific), number of readmissions per patient included, and whether mortality was considered a separate or composite outcome. The type of statistical association (univariate or multivariate) between social factors and readmission or mortality was abstracted.…”

“…Similar to CAP, most HF studies (17) were based on administrative data sets. Twenty-two used a combination of administrative database and medical record or interview, and 13 used only medical record or interview.…”