Postdischarge Mortality Up for Patients With Heart Failure
Of conditions targeted by Hospital Readmissions Reduction Program, only heart failure mortality increased
FRIDAY, Jan. 24, 2020 (HealthDay News) -- Patients with heart failure, but not those with acute myocardial infarction or pneumonia, have demonstrated an increase in postdischarge 30-day mortality, according to a study published online Jan. 15 in The BMJ.
Rohan Khera, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a retrospective cohort study involving Medicare claims data for 2008 to 2016 for patients aged 65 years or older admitted with conditions included in the U.S. Hospital Readmissions Reduction Program. Postdischarge 30-day mortality was examined according to patients' 30-day acute care utilization.
The researchers found that the overall postdischarge 30-day mortality was 8.7, 7.3, and 8.4 percent for heart failure, acute myocardial infarction, and pneumonia, respectively. For heart failure, acute myocardial infarction, and pneumonia, risk-adjusted mortality increased annually by 0.05 percent, decreased by 0.06 percent, and did not change significantly, respectively. Patients with heart failure who did not utilize any postdischarge acute care had an increase in mortality at a rate of 0.08 percent per year, exceeding the overall absolute annual increase in postdischarge mortality in heart failure, with no increase seen in mortality in observation units or the emergency department.
"Our research results were reassuring," Khera said in a statement. "We found that although the use of observation units and the emergency department as avenues of care in the posthospitalization period has increased in recent years, there was no increase in mortality risk in these settings."
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.