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Eastern Regional Meeting Abstracts

Risk Factors for All-Cause Readmission after Heart Failure Admission in Patients with Preserved or Reduced Ejection Fraction Jonathan S. Siegfried, Ofer Sagiv, Eric Berkowitz, Yuri Takhalov, Alaeldin Eltom, Suhash Patel, Ralph Benjamin, Benyam Alemu, Deepinder Osahan, Jennifer Siller, Jennifer Ullman, Georgia Panagopoulos, Frank Messineo, Neil L. Coplan. Department of Cardiovascular Medicine, Lenox Hill Hospital, New York, NY, United States. Purpose of Study: Acute decompensated heart failure (HF) is a major cause of hospital admissions in the US. Readmission within 30 days after an index HF hospitalization is common and portends a poor prognosis, regardless of ejection fraction (EF). The aim of this study was to determine the rate of readmission after an index HF admission and to identify risk factors associated with readmission in patients with both normal and reduced EF Methods Used: Consenting patients with an index admission for HF at a single medical center were followed prospectively for 30 days. Data regarding demographics, risk factors and discharge plan was collected during the index admission and during any readmission to the center within 30 days. Patients who were not re-admitted within 30 days were contacted and interviewed via telephone for admissions elsewhere. Summary of Results: 136 patients were enrolled in the study. 3 died during the index admission and were excluded from the analysis. 85 (63.9%) patients had a reduced EF (?50%) and 46 (34.6%) had a normal EF; 2 had no EF recorded and were excluded. Overall, 40 (30%) were readmitted within 30 days. There was no significant difference in readmission rates between patients with normal EF and patients with reduced EF (15/46 [33%] vs 25/85 [29%], p=0.43). Patients with a reduced EF were more likely to be readmitted if they had a history of coronary artery disease (CAD, 20/53 [37%] vs 5/32 [15.6%], p= 0.025) or a history of stroke (6/11 [54.5%] vs 18/73 [24.7%], p=0.038). History of CAD did not impart increased risk in patients with normal EF (7/21 [33.3%] vs 8/25 [32.0%], p=0.59). There were no patients with history of stroke and normal EF. Use of beta-blockers, ACE inhibitors and aldosterone antagonists did not have a significant effect on readmissions in patients with either reduced or normal EF. Conclusions: After an index HF admission, all-cause readmission rates within 30 days were similar in patients with normal EF and those with reduced EF. History of CAD or stroke was associated with increased risk of readmission in patients with reduced EF but not in patients with normal EF, while HF medications had little effect in either group.