Abstract: TH-PO0761
30-Day Readmissions for Patients Hospitalized with Acute Right Heart Failure and Chronic Thromboembolic Pulmonary Hypertension with AKI: A Nationwide Readmission Analysis
Session Information
- AKI: Critical Care, CKRT, Cardiorenal Syndromes, and Clinical Outcomes
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Bhatt, Parjanya K., Trinity Health Oakland Hospital, Pontiac, Michigan, United States
- Hirani, Chetna N., Trinity Health Oakland Hospital, Pontiac, Michigan, United States
- Vora, Tanisha, Trinity Health Oakland Hospital, Pontiac, Michigan, United States
- Shah, Rushi, Trinity Health Oakland Hospital, Pontiac, Michigan, United States
- Urhoghide, Eseosa Omosivie, Authority Health, Detroit, Michigan, United States
- Hanna, James, Trinity Health Oakland Hospital, Pontiac, Michigan, United States
Background
Chronic thromboembolic pulmonary hypertension (CTEPH) complicated by acute right heart failure (RHF) is associated with substantial morbidity and recurrent hospitalization. We evaluated the association of acute kidney injury (AKI) with index hospitalization mortality and 30-day all-cause readmission among patients hospitalized with acute RHF and CTEPH.
Methods
We performed a retrospective cohort study using the 2022 Nationwide Readmissions Database. Adult hospitalizations with acute RHF and CTEPH were identified using ICD-10-CM codes and stratified by AKI status. Survey-weighted analyses were used to obtain national estimates. Multivariable logistic regression evaluated predictors of mortality among index hospitalizations, while survey-weighted Cox proportional hazards regression assessed predictors of 30-day all-cause readmission among survivors, adjusted for demographics, hospital characteristics, illness severity, and comorbidity burden.
Results
A total of 527 weighted index hospitalizations with acute RHF and CTEPH were identified, including 272 complicated by AKI and 255 without AKI. Patients with AKI had a greater comorbidity burden, with a Charlson comorbidity index ≥5 in 41.4% versus 16.5% (p=0.005). AKI was associated with higher rates of sepsis (15.6% vs 3.4%, p=0.001), septic shock (13.5% vs 1.5%, p=0.001), mechanical ventilation (15.6% vs 3.4%, p=0.034), and palliative care encounters (16.6% vs 6.5%, p=0.014). Among survivors, 30-day all-cause readmission was higher in the AKI group (25.8% vs 16.3%). In multivariable Cox regression, AKI independently predicted increased 30-day readmission risk (aHR 2.6, 95% CI 1.17–5.59, p=0.019). AKI was not independently associated with index hospitalization mortality. Mechanical ventilation (aOR 47.1, 95% CI 3.83–579, p=0.003) and palliative care encounter (aOR 76.7, 95% CI 16.4–359, p<0.001) were independently associated with higher mortality.
Conclusion
Among patients hospitalized with acute RHF and CTEPH, AKI identified a clinically vulnerable phenotype characterized by greater illness severity and significantly increased risk of 30-day readmission. These findings highlight the prognostic importance of cardiorenal dysfunction in CTEPH and support intensified post-discharge renal monitoring and multidisciplinary transitional care strategies.