Causes, Predictors, and Costs of Unplanned 30-Day Readmissions in Patients with Right Heart Failure.

Abstract

OBJECTIVES: The aim of this study was to describe the frequency, causes, factors, and costs associated with right heart failure encounters. BACKGROUND: Multiple studies have looked into heart failure readmissions but there is no study to our knowledge specifically analyzing patients with right heart failure. METHODS: Patients with right heart failure diagnosis were identified using the 2017 Nationwide Readmission Database (NRD) and were evaluated for the rates, predictors, and costs of unplanned 30 days readmission. Weighted analysis was performed to obtain nationally representative data. RESULTS: We identified 7142 patients with right heart failure of whom 21% had an unplanned readmission within 30 days of the index discharge. Patients with history of Coronary artery bypass grafting (p=0.033; OR 2.359; 95% CI 1.071 to 5.197), Chronic kidney disease (p<0.001; OR 1.607; 95% CI 1.402 to 1.843), atrial fibrillation (p=0.014; OR 1.417; 95% CI 1.072 to 1.873) had high odds of unplanned 30 day readmissions while obesity (p<0.001; OR 0.686; 95% CI 0.594 to 0.792) had negative odds of such readmissions. CONCLUSIONS: Thirty-day unplanned readmissions remain a significant issue affecting over 1 in 5 patients with right heart failure. Early unplanned readmissions are associated with significant mortality and financial burden in these patients.