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81 Why do patients with concomitant HF and COPD return to hospital? risk factors and reasons for short-term readmission
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  1. Claudia Gulea1,
  2. Rosita Zakeri2,
  3. Jennifer K Quint3
  1. 1National Heart and Lung Institute, Imperial College London
  2. 2National Heart and Lung Institute, Imperial College London
  3. 3National Heart and Lung Institute, Imperial College London

Abstract

Background COPD is one of the most frequent comorbidties in HF and COPD exacerbations are a competing cause of hospitalisation in this patient group. We evaluated the causes and predictors of 30-day readmission in a large population of patients hospitalised for HF with comorbid COPD.

Methods We identified 54,953 patients hospitalised for HF with a comorbid diagnosis of COPD in the National Readmissions Database in the United States, in 2012. Using Cox proportional hazards regressions we evaluated factors associated with 30-day all-cause, respiratory and cardiovascular (CV)-related readmissions. The primary cause of readmission was identified using ICD–9CM codes.

Results The most common cause for readmission was CV (50.5%), while the most frequent cause for non-CV readmission was respiratory disease (13%). Factors associated with 30-day all-cause readmission included: Renal failure (HR 1.24, 95% CI 1.19 - 1.30), anaemia (HR 1.14, 95% CI 1.09 - 1.19), weight loss (HR 1.14, 95% CI 1.05 - 1.24), diabetes (HR 1.09, 95% CI 1.04 - 1.14), and index hospitalisation length of stay over 10 days (HR 1.45, 95%CI 1.36 - 1.55, Figure 1). Respiratory-related readmission was positively associated with recent weight loss (HR 1.37, 95% CI 1.09 - 1.71), depression (HR 1.21, 95% CI 1.02 - 1.44), obesity (HR 1.17, 95% CI 1.02 - 1.36) and length of stay over 10 days (HR 1.86, 95% CI 1.54 - 2.25). Major risk factors for CV readmission were renal failure (HR 1.42, 95% CI 1.33 - 1.51), coronary artery disease (HR 1.18, 95%CI 1.11 - 1.26) and diabetes (HR 1.18, 95% CI 1.10 - 1.24).

Abstract 81 Figure 1

Hazard ratio

Conclusion In patients hospitalised for HF with comorbid COPD, most readmissions are still due to a CV cause; however, several non-cardiac risk factors significantly contribute to readmission risk. These data highlight an opportunity to better assess and treat non-cardiac comorbidities in order to reduce readmissions in this high-risk population.

Conflict of Interest None

  • heart failure
  • chronic obstructive pulmonary disease
  • readmission

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