Abstract 16128: Association Between Timing of Readmission and Risk of 1-year Mortality Among Patients After Hospitalization for Heart Failure in China: Findings From the China-PEACE Prospective Heart Failure Study
Introduction: Although 30-day readmission has been used as a quality metric for treatment of patients hospitalized for heart failure (HF), the association between the timing of readmission with mortality after discharge has been scarcely investigated. Methods: We studied a national sample of 4875 patients admitted to 52 hospitals for HF between 2016 and 2018 who were discharged alive from the China PEACE-Heart Failure Study. The timing of readmission was defined as the timing of first readmission from all cause after discharge. Mortality analyses across the timing of readmission were performed using Kaplan-Meier curves and log-rank tests. The associations between the timing of readmission and 1-year all-cause mortality was determined using Cox models. Results: The median participant age was 67 (57-76) years, and 37.5% were female. The median duration from discharge to readmission was 88 (28-194) days. Kaplan-Meier analysis revealed 1-year mortality did not differ between patients admitted within 0-30 and 31-60 days, and between patients admitted within 61-90 and 91-180 days after discharge (Figure1A). Then we classified the timing of readmission as early (0-60 days), midrange (61-180 days) and late (181-365 days). The 1-year all-cause mortality for patients experiencing early, midrange and late readmission was 31.8%, 23.2% and 12.0%, respectively (Figure1B). After adjusting for patient characteristics and treatment during hospitalization, the HR for 1-year all-cause mortality was 2.89 (95% CI 2.22-3.77) for patients with early readmission, and 2.07 (95% CI 1.56-2.75) for patients with midrange readmission when compared with patients with late readmission, respectively. Conclusions: Earlier readmission are associated with increased risk for 1-year all-cause mortality. Not only 30-day readmission but also readmission within 60 days after discharge could be perceived as an alarming sign of higher risk of death in patients with hospitalized HF in China.