In-Hospital Mortality Rate and Predictors of 30-Day Readmission in Patients With Heart Failure Exacerbation and Atrial Fibrillation: A Cross-Sectional Study.

Abstract

Background and objectives: Heart failure (HF) and atrial fibrillation (AF) are considered new cardiovascular epidemics of the last decade. Recent national trends show an uptrend in HF hospitalizations. We aimed to identify the 30-day readmission rate, causes, and impact on healthcare utilization in HF exacerbation with a history of AF.

Methods: We utilized 2018 Nationwide readmission data and included patients aged ≥18 years with International Classification of Diseases, Tenth Revision, Clinical Modification code indicating HF exacerbation and AF were included in the study. Primary outcome is 30-day readmission rates. Secondary outcomes were mortality rates, common causes of readmission, and healthcare utilization. Independent predictors for readmission were identified using cox regression analysis.

Results: The total number of admissions in our study was 48,250. The mean age was 77.8 years (standard deviation, 12.1), and 47.74% were females. The 30-day readmission rate was 16.72%. The mortality rate at index admission and readmission was 7.28% and 8.12%, respectively. The most common cause of readmission was the hypertensive heart and kidney disease with HF. The independent predictors of readmission were low socio-economic class, Medicaid, Charlson comorbidities score. The financial burden on healthcare for all the readmission was $461 million for the year 2018.

Conclusions: The 30-day readmission rate was 16.72%. The mortality rate increased from 7.28% to 8.12% with readmission. The financial burden for readmission during that year was $461 million. Future studies directed with interventions to prevents readmissions are warranted.