30-Day Readmission Rates in Patients Admitted for Heart Failure Exacerbation with and without Palliative Care Consultation: A Retrospective Cohort Study

Abstract Background Palliative Performance Scale (PPS) has been frequently used to estimate the survival time of palliative care patients. The objective was to determine the associations between the PPS and survival time among cancer and non-cancer patients in Thailand. Methods This is a retrospective cohort study. All in-patient adults who received a palliative care consultation at Chiang Mai University Hospital between 1 July 2018 to 31 July 2019 were included in the study and were followed-up until 26 June 2020. The Palliative Performance Scale was assessed using the validated Thai-Palliative Performance Scale for Adults. Survival analysis was used to determine the association between the Palliative Performance Scale and survival time among cancer and non-cancer patients. Results Out of 407 patients, 220 were male (54.1%). There were 307 cancer patients (75.4%) and 100 non-cancer patients (24.6%). The PPS and survival time in cancer patients were significantly correlated. Cancer patients with PPS 10, 20, 30, 40–60, and 70–80% had a median survival time of 2, 6, 13, 39, and 95 days, respectively. Non-cancer patients with PPS 10, 20, and 30% had a median survival time of 8, 6, and 24 days, respectively. Conclusions While useful for estimating survival time for cancer patients, other factors should be taken into account in estimating the survival time for non-cancer patients.

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Iron deficiency in 78 805 people admitted with heart failure across England: a retrospective cohort study

Open Heart ◽

10.1136/openhrt-2019-001153 ◽

2020 ◽

Vol 7 (1) ◽

pp. e001153 ◽

Cited By ~ 2

Author(s):

James M Beattie ◽

Rani Khatib ◽

Ceri J Phillips ◽

Simon G Williams

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Iron Deficiency ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Primary Diagnosis ◽

Adverse Outcomes ◽

Health Economy ◽

Inpatient Mortality ◽

Readmission Rates

ObjectivesIron deficiency (ID), with or without anaemia (IDA), is an important comorbidity in people with chronic heart failure (HF), but the prevalence and significance in those admitted with HF is uncertain. We assessed the prevalence of ID or IDA in adults (age ≥21 years) hospitalised with a primary diagnosis of HF, and examined key metrics associated with these secondary diagnoses.MethodsA retrospective cohort study of Hospital Episode Statistics describing all adults admitted to National Health Service (NHS) hospitals across England from April 2015 through March 2016 with primary diagnostic discharge coding as HF, with or without subsidiary coding for ID/IDA.Results78 805 adults were admitted to 177 NHS hospitals with primary coding as HF: 26 530 (33.7%) with secondary coding for ID/IDA, and 52 275 (66.3%) without. Proportionately more patients coded ID/IDA were admitted as emergencies (94.8% vs 87.6%; p<0.0001). Tending to be older and female, they required a longer length of stay (15.8 vs 12.2 days; p<0.0001), with higher per capita costs (£3623 vs £2918; p<0.0001), the cumulative excess expenditure being £21.5 million. HF-related (8.2% vs 5.2%; p<0.0001) and all-cause readmission rates (25.8% vs 17.7%; p<0.05) at ≤30 days were greater in those with ID/IDA against those without, and they manifested a small but statistically significant increased inpatient mortality (13.5% v 12.9%; p=0.009).ConclusionsFor adults admitted to hospitals in England, principally with acute HF, ID/IDA are significant comorbidities and associated with adverse outcomes, both for affected individuals, and the health economy.

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PALLIATIVE CARE CONSULTATION REDUCES 30-DAY READMISSION RATES FOR HOSPITALIZED PATIENTS WITH HEART FAILURE: A SINGLE-CENTER EXPERIENCE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31320-2 ◽

2018 ◽

Vol 71 (11) ◽

pp. A779 ◽

Cited By ~ 1

Author(s):

Kalyan Potu ◽

Jay Patel ◽

Sandeep Banga ◽

Sravani Avula ◽

Ashish Roy ◽

...

Keyword(s):

Heart Failure ◽

Palliative Care ◽

Hospitalized Patients ◽

Single Center ◽

Readmission Rates ◽

Single Center Experience ◽

Palliative Care Consultation ◽

Patients With Heart Failure ◽

Care Consultation

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Association of Palliative Care Consultation with Advance Directive Completion for Patients Admitted with an Acute Heart Failure Exacerbation

Journal of Maine Medical Center ◽

10.46804/2641-2225.1056 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Michelle Crispo ◽

Doug Sawyer ◽

Kathleen Fairfield ◽

Rebecca N. Hutchinson

Keyword(s):

Heart Failure ◽

Palliative Care ◽

Acute Heart Failure ◽

Advance Directive ◽

Palliative Care Consultation ◽

Care Consultation ◽

Heart Failure Exacerbation

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Electrocardiography as a prognostic tool for identifying the development of heart failure in patients with β-thalassaemia: a retrospective cohort study

Primary Care Cardiovascular Journal (PCCJ) ◽

10.3132/pccj.2008.013 ◽

2008 ◽

Vol 1 (1) ◽

pp. 51

Author(s):

Mohammed Nabil Quraishi ◽

Sarah Lawson ◽

Paramjit S Gill

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prognostic Tool

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Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups

BMJ Open ◽

10.1136/bmjopen-2020-044196 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044196

Author(s):

Madalene Earp ◽

Pin Cai ◽

Andrew Fong ◽

Kelly Blacklaws ◽

Truong-Minh Pham ◽

...

Keyword(s):

Palliative Care ◽

Cohort Study ◽

Heart Disease ◽

Chronic Disease ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hospital Admissions ◽

Specialist Palliative Care ◽

Icu Admission

ObjectiveFor eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.DesignRetrospective cohort study using administrative data.SettingAlberta, Canada between 2007 and 2016.Participants47 169 adults deceased from: (1) cancer, (2) heart disease, (3) dementia, (4) stroke, (5) chronic lower respiratory disease (chronic obstructive pulmonary disease (COPD)), (6) liver disease, (7) neurodegenerative disease and (8) renovascular disease.Main outcome measuresThe proportion of decedents who experienced high hospital-based acute care in the last 30 days of life, indicated by ≥two emergency department (ED) visit, ≥two hospital admissions,≥14 days of hospitalisation, any intensive care unit (ICU) admission, or death in hospital. Relative risk (RR) and risk difference (RD) of hospital-based acute care given early specialist PC exposure (≥90 days before death), adjusted for patient characteristics.ResultsIn an analysis of all decedents, early specialist PC exposure was associated with a 32% reduction in risk of any hospital-based acute care as compared with those with no PC exposure (RR 0.69, 95% CI 0.66 to 0.71; RD 0.16, 95% CI 0.15 to 0.17). The association was strongest in cancer-specific analyses (RR 0.53, 95% CI 0.50 to 0.55; RD 0.31, 95% CI 0.29 to 0.33) and renal disease-specific analyses (RR 0.60, 95% CI 0.43 to 0.84; RD 0.22, 95% CI 0.11 to 0.34), but a~25% risk reduction was observed for each of heart disease, COPD, neurodegenerative diseases and stroke. Early specialist PC exposure was associated with reducing risk of four out of five individual indicators of high hospital-based acute care in the last 30 days of life, including ≥two ED visit,≥two hospital admission, any ICU admission and death in hospital.ConclusionsEarly specialist PC exposure reduced the risk of hospital-based acute care in the last 30 days of life for all chronic disease groups except dementia.

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