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• W4365150432 abstract "Introduction . Heart failure (HF) patients frequently have multiple comorbidities. Medicare and Medicaid Services data show that 55% of patients with HF present more than five chronic comorbidities, such as chronic lung disease, sleep disordered breathing, renal disease, cognitive dysfunction, and diabetes mellitus. Coexisting comorbidities can cause worsening symptoms of HF and worse patient outcomes. Charlson Comorbidity Index (CCI) has been used in the past to assess comorbidity burden in patients admitted for in-hospital treatment. Aim To examine how Charlson Comorbidity Index (CCI) at the time of hospital discharge impacts 30-day rehospitalization rate. Methods . This was a retrospective cross-sectional study using electronic health record data on patients admitted for HF between June 1, 2015 and December 31, 2019 to a tertiary hospital. 30-day rehospitalization was defined as a subsequent hospitalization occurring within 30 days after hospital discharge. CCI score was calculated by the summarization of the assigned weights of all comorbidities. After accounting for baseline age, gender, race, ethnicity, marriage status, BMI, blood pressure, pulse, LVEF, length of stay, alcohol use, and smoking status, the stepwise procedure for model selection was conducted to examine associations between CCI score and 30-day rehospitalization in SAS™ version 9.4. Results . There were 5,083 patients discharged from the hospital for a diagnosis of HF exacerbation during the study period after eliminating multiple 30-day rehospitalizations. The mean age was 76.5 years (SD±7.6), 54% were male, and 89.2% were white. The mean CCI score in the rehospitalized group was 7.4 (SD±3) and 6.8 (SD±2.8) in the non-rehospitalized group: the odds of being rehospitalized were 1.07 (p <0.0001). The top five co-morbidities were diabetes mellitus (44.8%), renal disease (42.3%), chronic pulmonary disease (34.8%), myocardial infarction (31.6%), and peripheral vascular disease (23.1%). Among the most common comorbidities, having a renal disease was significantly associated with 30-day rehospitalization (OR:1.33, p=0.0169). Although not among the most common comorbidities, having a malignant tumor (14.5% of HF patients) was significantly associated with 30-day rehospitalization (OR: 2.13, p <0.0001). Conclusions This study shows that HF patients with higher CCI score (>7.4) at hospital discharge are at greater risk of being rehospitalization within 30 days of hospital discharge. Having a renal disease and a malignant tumor drove the risk for 30-day rehospitalization. Increased cardiac monitoring of patients being treated for malignant tumors may help to decrease HF resulting in the need for hospitalization. Future studies may need to consider evaluating the risk factors for 30-day rehospitalization in cancer patients who go into HF." @default.
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• W4365150432 date "2023-04-01" @default.
• W4365150432 modified "2023-10-17" @default.
• W4365150432 title "Charlson Comorbidity Index Score And 30day Rehospitalization In Heart Failure Patients" @default.
• W4365150432 doi "https://doi.org/10.1016/j.cardfail.2022.10.312" @default.
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