The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure

Andrea Driscoll, Diem Dinh, David Prior, David Kaye, David Hare, Christopher Neil, Siobhan Lockwood, Angela Brennan, Jeff Lefkovits, Harriet Carruthers, John Amerena, Jennifer C. Cooke, Gautam Vaddadi, Voltaire Nadurata, Christopher M. Reid

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6 Citations (Scopus)

Abstract

Background: Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. Methods: This was a prospective, observational, non-randomised study of consecutive patients hospitalised with acute HF to one of 16 Victorian hospitals over a 30-day period each year and followed up for 30 days post-discharge. The project was conducted annually over three consecutive years from 2015 to 2017. Results: Of the 1,197 patients, 56.3% were male with an average age of 77±13.23 years. Over half of the patients (711, 62.5%) were referred to an outpatient clinic and a third (391, 34.4%) to a HF disease management program. In-hospital mortality was 5.1% with 30 day-mortality of 9% and readmission rate of 24.4%. Patients who experienced a subsequent readmission less than 10 days post-discharge and between 11 and 20 days post-discharge had a five- to six-fold increase in risk of mortality (adjusted OR 5.02, 95% CI 2.11–11.97; OR 6.45, 95% CI 2.69–15.42; respectively) compared to patients who were not readmitted to hospital. An outpatient appointment within 30 days post-discharge significantly reduced the risk of 30-day mortality by 81% (95% CI 0.09–0.43). Conclusion: Patients admitted to hospital with AHF who experience a subsequent readmission within 20 days post-discharge are at increased risk of dying. However, early follow-up post-discharge may reduce this risk. Early post-discharge follow-up is vital to address this vulnerable period after a HF admission.

Original languageEnglish
Pages (from-to)1347-1355
Number of pages9
JournalHeart Lung and Circulation
Volume29
Issue number9
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Heart failure
  • Mortality
  • Registry
  • Transitional care

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