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Kidney Week

Abstract: PO0582

Association of CKD with Early Heart Failure Readmissions in Adults

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Li, Si, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Wang, Yichen, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Elavia, Nasha, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Milekic, Bojana, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
Background

Heart failure is a complex chronic disease with multiple comorbidities that contribute to frequent hospitalization. We aimed to examine the impact of chronic kidney disease on the 30-day readmission rate among patients hospitalized with heart failure.

Methods

We performed a retrospective analysis of the National Readmission Database (NRD) 2016- 2017. We identified adult patients with a primary hospital diagnosis of heart failure. We compared baseline demographics and calculated all-cause 30-day readmission rates. Multivariate survey logistic regression was used to identify predictors of readmission.

Results

We identified a total of 865,328 patients admitted with heart failure. 839,625 patients were discharged alive. Among which 181,130 (21.5%) had at least one readmission within 30 days. The in-hospital mortality of index admissions and readmissions was 2.9% and 6.5%, respectively. The 30-day inpatient mortality was 4.0%. The mean length of stay of index admission and readmissions were 5.3 days and 6.4 days, respectively. The most common reasons for all-cause readmissions were acute on chronic heart failure (systolic, diastolic, combined), hypertensive heart and chronic kidney disease with heart failure, sepsis, acute kidney failure. After adjusting for multiple covariates, 30-day readmission was independently associated with chronic kidney disease [adjusted odds ratio (aOR) 1.2, 95% confidence interval (CI) 1.17- 1.23, p<0.001], coronary artery disease (aOR 1.01, 95% CI 1.07- 1.11), chronic obstructive pulmonary disease (COPD) (aOR 1.20, 95% CI 1.18- 1.22). Younger age, lower-income, discharge from larger hospitals were also predictive.

Conclusion

Further prospective studies with focus on multilevel interventions are needed to help reduce early readmission associated significant morbidity and resource utilization for this high-risk population.