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Readmissions in Heart Failure Patients: a Portuguese Administrative Database Study from 2008 to 2018
Session:
Posters - D. Heart Failure
Speaker:
Marisa Pardal
Congress:
CPC 2021
Topic:
D. Heart Failure
Theme:
11. Acute Heart Failure
Subtheme:
11.2 Acute Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Marisa Pardal
Abstract
<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><strong>Objectives:</strong> The primary objective of this study was to analyze the readmissions evolution pattern and characterize readmitted heart failure (HF) patients in the Portuguese National Health Service (NHS) between 2008 and 2018. </span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><strong>Methods:</strong> This is a retrospective longitudinal study that used inpatient discharge data set from all mainland Portuguese NHS public hospitals. For each civil year, admissions of HF diagnosed patients (as primary or secondary diagnosis) were identified through ICD-9-CM and ICD-10-CM codes. Readmitted patients were selected to calculate: 1) the total number of readmissions; 2) the mean number of readmissions; the proportion of readmissions at 30, 90 and 120 days after first admission discharge. Sociodemographic characteristics (age, gender and residency district) and clinical characteristics (cardiovascular and non-cardiovascular comorbidities) were used to understand readmitted patients profile. </span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><strong>Results:</strong> From 2008 to 2018, a total of 770 844 admissions in HF patients were registered, from which 20.9% (in 2008) and 26.1% (in 2018) corresponded to readmissions. For each civil year, the majority of readmissions (>70%) occurred until 90 days after discharge. 30 days readmission after discharge proportion increased between 2008 (39.5%) and 2011 (46.4%) and sustained until 2018. Between 2008 and 2018, 30 day readmissions increased by 20%. The number of HF readmitted patients has been rising since 2008, with a proportion varying between 18.5% in 2008 and 19.8% in 2018. The majority of patients had 1 readmission, with a rise in the mean number of readmissions: 1.43 in 2008 and 1.78 in 2018. HF readmitted patients were mostly women (53-55%) and had a mean age that varied between 73.6 years old in 2008 and 79.4 years old in 2018. The majority of HF readmitted patients were from Lisbon and Porto. Hypertension was the most prevalent comorbidity, identified in 56% to 73% of readmitted patients with an increase of 17.4% between 2008 and 2018. Atrial fibrillation diagnose also increased within the study period, varying between 36.8% in 2008 and 48.7% in 2008. Type 2 diabetes <em>mellitus</em> was also a frequent diagnose in readmitted HF patients (34.4% to 39.3%) and chronic obstructive pulmonary disease was the less frequent comorbidity, identified in 17-19% of the patients. </span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><strong>Conclusions:</strong> The number of admissions and readmissions in HF patients has been growing in the last years. Readmissions are associated with a worse prognosis, increased mortality and represent a significant burden for health systems. Mean age of HF readmitted patients is increasing, as well as the comorbidity burden, which demands for an integrated multidisciplinary approach in the care continuum.</span></span></p>
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