The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure
Background: Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. Methods: This was a prospective, obser...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER SCIENCE INC
2020
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93776 |
| _version_ | 1848765786909310976 |
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| author | Driscoll, A. Dinh, D. Prior, D. Kaye, D. Hare, D. Neil, C. Lockwood, S. Brennan, A. Lefkovits, J. Carruthers, H. Amerena, J. Cooke, J.C. Vaddadi, G. Nadurata, V. Reid, Christopher |
| author_facet | Driscoll, A. Dinh, D. Prior, D. Kaye, D. Hare, D. Neil, C. Lockwood, S. Brennan, A. Lefkovits, J. Carruthers, H. Amerena, J. Cooke, J.C. Vaddadi, G. Nadurata, V. Reid, Christopher |
| author_sort | Driscoll, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. Methods: This was a prospective, observational, non-randomised study of consecutive patients hospitalised with acute HF to one of 16 Victorian hospitals over a 30-day period each year and followed up for 30 days post-discharge. The project was conducted annually over three consecutive years from 2015 to 2017. Results: Of the 1,197 patients, 56.3% were male with an average age of 77±13.23 years. Over half of the patients (711, 62.5%) were referred to an outpatient clinic and a third (391, 34.4%) to a HF disease management program. In-hospital mortality was 5.1% with 30 day-mortality of 9% and readmission rate of 24.4%. Patients who experienced a subsequent readmission less than 10 days post-discharge and between 11 and 20 days post-discharge had a five- to six-fold increase in risk of mortality (adjusted OR 5.02, 95% CI 2.11–11.97; OR 6.45, 95% CI 2.69–15.42; respectively) compared to patients who were not readmitted to hospital. An outpatient appointment within 30 days post-discharge significantly reduced the risk of 30-day mortality by 81% (95% CI 0.09–0.43). Conclusion: Patients admitted to hospital with AHF who experience a subsequent readmission within 20 days post-discharge are at increased risk of dying. However, early follow-up post-discharge may reduce this risk. Early post-discharge follow-up is vital to address this vulnerable period after a HF admission. |
| first_indexed | 2025-11-14T11:40:47Z |
| format | Journal Article |
| id | curtin-20.500.11937-93776 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:47Z |
| publishDate | 2020 |
| publisher | ELSEVIER SCIENCE INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937762023-12-21T05:53:35Z The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure Driscoll, A. Dinh, D. Prior, D. Kaye, D. Hare, D. Neil, C. Lockwood, S. Brennan, A. Lefkovits, J. Carruthers, H. Amerena, J. Cooke, J.C. Vaddadi, G. Nadurata, V. Reid, Christopher Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Transitional care Registry Mortality MEDICARE BENEFICIARIES MANAGEMENT GUIDELINES MORTALITY ADMISSION TRENDS Heart failure Mortality Registry Transitional care Acute Disease Aged Female Heart Failure Hospital Mortality Humans Inpatients Male Morbidity Patient Readmission Prospective Studies Risk Factors Stroke Volume Survival Rate Transitional Care Victoria Humans Acute Disease Stroke Volume Patient Readmission Morbidity Hospital Mortality Survival Rate Risk Factors Prospective Studies Aged Inpatients Victoria Female Male Heart Failure Transitional Care Background: Patients admitted to hospital with acute heart failure (AHF) are at increased risk of readmission and mortality post-discharge. The aim of the study was to examine health service utilisation within 30 days post-discharge from an AHF hospitalisation. Methods: This was a prospective, observational, non-randomised study of consecutive patients hospitalised with acute HF to one of 16 Victorian hospitals over a 30-day period each year and followed up for 30 days post-discharge. The project was conducted annually over three consecutive years from 2015 to 2017. Results: Of the 1,197 patients, 56.3% were male with an average age of 77±13.23 years. Over half of the patients (711, 62.5%) were referred to an outpatient clinic and a third (391, 34.4%) to a HF disease management program. In-hospital mortality was 5.1% with 30 day-mortality of 9% and readmission rate of 24.4%. Patients who experienced a subsequent readmission less than 10 days post-discharge and between 11 and 20 days post-discharge had a five- to six-fold increase in risk of mortality (adjusted OR 5.02, 95% CI 2.11–11.97; OR 6.45, 95% CI 2.69–15.42; respectively) compared to patients who were not readmitted to hospital. An outpatient appointment within 30 days post-discharge significantly reduced the risk of 30-day mortality by 81% (95% CI 0.09–0.43). Conclusion: Patients admitted to hospital with AHF who experience a subsequent readmission within 20 days post-discharge are at increased risk of dying. However, early follow-up post-discharge may reduce this risk. Early post-discharge follow-up is vital to address this vulnerable period after a HF admission. 2020 Journal Article http://hdl.handle.net/20.500.11937/93776 10.1016/j.hlc.2020.03.004 English http://purl.org/au-research/grants/nhmrc/1136372 ELSEVIER SCIENCE INC restricted |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Transitional care Registry Mortality MEDICARE BENEFICIARIES MANAGEMENT GUIDELINES MORTALITY ADMISSION TRENDS Heart failure Mortality Registry Transitional care Acute Disease Aged Female Heart Failure Hospital Mortality Humans Inpatients Male Morbidity Patient Readmission Prospective Studies Risk Factors Stroke Volume Survival Rate Transitional Care Victoria Humans Acute Disease Stroke Volume Patient Readmission Morbidity Hospital Mortality Survival Rate Risk Factors Prospective Studies Aged Inpatients Victoria Female Male Heart Failure Transitional Care Driscoll, A. Dinh, D. Prior, D. Kaye, D. Hare, D. Neil, C. Lockwood, S. Brennan, A. Lefkovits, J. Carruthers, H. Amerena, J. Cooke, J.C. Vaddadi, G. Nadurata, V. Reid, Christopher The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title | The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title_full | The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title_fullStr | The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title_full_unstemmed | The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title_short | The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure |
| title_sort | effect of transitional care on 30-day outcomes in patients hospitalised with acute heart failure |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Transitional care Registry Mortality MEDICARE BENEFICIARIES MANAGEMENT GUIDELINES MORTALITY ADMISSION TRENDS Heart failure Mortality Registry Transitional care Acute Disease Aged Female Heart Failure Hospital Mortality Humans Inpatients Male Morbidity Patient Readmission Prospective Studies Risk Factors Stroke Volume Survival Rate Transitional Care Victoria Humans Acute Disease Stroke Volume Patient Readmission Morbidity Hospital Mortality Survival Rate Risk Factors Prospective Studies Aged Inpatients Victoria Female Male Heart Failure Transitional Care |
| url | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93776 |