Abstract 309: Outcomes of Depressed Patients With and Without Antidepressant Prescription

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Ashley Francis ◽  
Rachel H Krallman ◽  
Delaney Feldeisen ◽  
Daniel G Montgomery ◽  
Eva M Kline-Rogers ◽  
...  
Keyword(s):  
Transitional Care ◽  
Additional Treatment ◽  
Cardiac Patients ◽  
Treatment Modalities ◽  
Post Discharge ◽  
Care Clinic ◽  
Antidepressant Prescription ◽  
Increased Risk ◽  
Antidepressant Use ◽  
Ed Visits

Background: Many studies have shown a relationship between depression and an increased risk of rehospitalization, suggesting assessment and management, potentially including antidepressants, should remain an important part of inpatient treatment. However, studies analyzing the outcomes associated with antidepressant use among cardiac patients have shown mixed results. This study aims to describe the long-term outcomes (ED visits, readmissions, and death) of a cohort of cardiac patients with concomitant depression treated with antidepressants. Methods: A total of 151 patients with a medical history of depression were randomly selected between 2008-2017 from a cardiac transitional care clinic registry. A retrospective chart review was conducted to determine the frequency of antidepressant prescription at discharge following a cardiac hospital admission. Demographics and outcomes were compared between those prescribed and those not prescribed antidepressants at discharge. Results: Of 4,298 patients, 1,067 (24.8%) had a diagnosis of depression recorded in their medical record. Of the 151 randomly selected depression patients, 106 (70.2%) were on at least one antidepressant at discharge. Significantly more females were prescribed antidepressants at discharge than males (78.0% v. 58.3%, p=0.010). No significant differences were seen in race, socioeconomic status, or outcomes at 30, 60, 90, or 180 days post-discharge between those prescribed and those not prescribed antidepressants at discharge. However, when compared to patients without depression (n=3,231), those on at least one antidepressant had significantly more 30-day ED visits (25.5% vs 17%, p=0.026), 180-day ED visits (52.9% vs 38.1%, p=0.002), and 180-day readmissions (55.8% vs 40.1%, p=0.001). Conclusions: Patients with depression had worse outcomes than those without depression, despite the majority (70.2%) being treated with antidepressants. These results suggest efforts should be made post-discharge to closely monitor patients with depression, even if they are prescribed antidepressants, and additional treatment modalities should be researched.

Abstract 304: Characteristics of Acute Coronary Syndrome Patients Referred to the Bridge Transitional Care Clinic By Time to Readmission

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
George Cholack ◽  
Joshua Garfein ◽  
Rachel H Krallman ◽  
Delaney Feldeisen ◽  
Daniel G Montgomery ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Transitional Care ◽  
Discharge Planning ◽  
Post Discharge ◽  
Care Clinic ◽  
Icu Admission ◽  
Coronary Syndrome ◽  
Female Sex ◽  
Increased Risk ◽  
Early Readmission

Introduction: Prompt follow-up post-discharge is recommended by many readmission reduction initiatives. Identifying predictors of early readmission may inform discharge planning. We compared characteristics of acute coronary syndrome (ACS) patients (pts) based on time to readmission to determine factors associated with early readmission. Methods: Pts referred to the BRIDGE transitional care clinic following index admission for ACS from 2008-2017 were eligible. Demographics and inpatient clinical characteristics were compared between pts readmitted early (0-7 days post-discharge) versus late (8-30 days post-discharge). Multivariable logistic regression models were created to identify independent predictors of early readmission. Results: Of 1220 ACS pts, 198 were readmitted within 30 days; 70 (35.4%) were readmitted early, and 10.0% of these were readmitted for ACS. Early readmissions were more likely to be female, have an ED visit prior to readmission, and have an index ICU admission. Female sex [OR: 2.26, 95% CI: 1.23, 4.16] and ICU admission [OR: 2.20, 95% CI: 1.14, 4.24] were both independent predictors of early readmission. Conclusion: Female sex and ICU admission during index were associated with roughly twice the odds of early readmission. Non-white pts were also more often readmitted early (p=0.05), suggesting potential care disparities in this population. Future studies to identify pts at increased risk of early readmission and efforts to reduce disparities are warranted.

Abstract 338: BRIDGE: A Post-Discharge Transitional Care Model in over 1600 Cardiac Patients

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Rachel Sylvester ◽  
Minnie Bluhm ◽  
William Froehlich ◽  
Meghana Subramanian ◽  
Alison Wiles ◽  
...  
Keyword(s):  
Transitional Care ◽  
Care Program ◽  
Clinic Visit ◽  
Cardiac Patients ◽  
Post Discharge ◽  
Readmission Rates ◽  
Care Clinic ◽  
Charlson Comorbidity Score ◽  
History Of

Background: Current legislation imposes financial penalties for high 30-day readmissions for AMI. BRIDGE is a NP-led, post-discharge transitional care program for cardiac patients, aimed at ensuring prompt follow up (f/u; in 14 days) and care coordination. Herein we report the effect of BRIDGE on readmissions in over 1600 cases. Methods: Retrospective data was abstracted for patients referred to BRIDGE including demographics, comorbidities, medications, days to f/u, and 6-month outcomes by diagnosis. Results: Of 1955 patients referred to the BRIDGE clinic, 271 (13.9%) were excluded for adverse events prior to their visit (ED visit n=60, readmission n=193, or death n=14) or missing data (n=4). 1210 (71.9%) of patients from the remaining sample (n=1684) attended BRIDGE. Diagnoses included: ACS (n=462, 27.6%); angina (n=207, 12.4%); CAD (n=196, 11.7%); AFib (n=247, 14.7%); CHF (n=316, 18.9%); or other (n=256, 15.2%). With the exception of mental health disorders (35.4% v. 29.1%, p=.012) there were no baseline differences (including the Charlson Comorbidity Score) between non-attendees and attendees (Table 1). ACS attendees, compared to non-attendees, had a trend toward lower 30, 60, and 90 day readmission rates (Table 2). This was not observed for other diagnoses. Conclusions: A NP based transitional care clinic visit early post-discharge appears to reduce early readmissions for patients with an ACS, but in this study did not impact other cardiac conditions. Also, patients with a history of substance abuse or depression are significantly less likely to attend BRIDGE appointments. To avoid a lapse in care, these patients may need prompt f/u with their PCP or cardiologist to help reduce early readmissions.

Abstract 097: Effects of BRIDGE Attendance on the Outcomes of Diabetic Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Caitlin Fette ◽  
Rachel Krallman ◽  
Colin McMahon ◽  
Daniel Montgomery ◽  
Jennifer Wang ◽  
...  
Keyword(s):  
Transitional Care ◽  
Care Program ◽  
Primary Diagnosis ◽  
Lower Mortality ◽  
Diabetic Patients ◽  
Post Discharge ◽  
Readmission Rates ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Discharge Outcomes

Background: Prior studies have shown that patients with diabetes mellitus (DM) have increased risk for developing cardiovascular disease. BRIdging the Discharge Gap Effectively (BRIDGE) is a nurse practitioner-delivered cardiac transitional care program for patients who have been recently discharged following a cardiac event. Previous research has shown BRIDGE to be effective in improving patient outcomes. This study sought to describe differences in outcomes 1) of heart failure (HF), acute coronary syndrome (ACS), and atrial fibrillation (AF) patients with and without concomitant DM, and 2) between diabetic patients who did and did not attend BRIDGE. Methods: Retrospective data were abstracted for HF, ACS, and AF patients from 2008-2014. Patients were divided into cohorts based on presence or absence of DM and BRIDGE attendance versus non-attendance. Outcomes (readmissions, ED visits, death) within each primary diagnosis (HF, ACS, AF) were compared between DM and non-DM patients and between those who attended BRIDGE versus those who did not for all DM patients. Results: Of 2197 patients referred to BRIDGE, 723 (32.9%) had concomitant DM. DM patients had similar outcomes to non-DM patients for most post-discharge outcomes; however, DM ACS patients had higher readmission (42.2% v 29.6%, p<0.001) and death (10.5% v. 4.5%, p=0.001) rates within 6 months, and DM AF patients had higher readmission rates within 6 months (52.1% v 37.9%, p=0.006). HF patients with DM who attended BRIDGE had lower mortality rates within 6 months of discharge than those who did not (10.3% vs. 22.1%, p=0.014). No other significant differences in outcomes were seen between BRIDGE attendees and non-attendees. Conclusions: Though not significant, patients with DM had worse post-discharge outcomes than those without DM for all primary diagnoses. In the subset of DM patients, the 30-day readmission rate for ACS patients who attended BRIDGE was half of those who did not attend. Conversely, 30-day readmission rates for HF patients were greater if they attended. This may in part explain the significantly lower mortality rate among BRIDGE attenders with HF, where patients who needed readmission were identified during their BRIDGE appointment. Due to the high prevalence of DM, efforts to tailor transitional care for this population are needed.

scholarly journals Frequent Emergency Department Visits After Spontaneous Intracerebral Hemorrhage: Who Is at Risk?

2018 ◽  
Vol 8 (4) ◽  
pp. 166-170
Author(s):  
Jerina Nogueira ◽  
Pedro Abreu ◽  
Patrícia Guilherme ◽  
Ana Catarina Félix ◽  
Fátima Ferreira ◽  
...  
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Intracerebral Hemorrhage ◽  
Hospital Discharge ◽  
Transitional Care ◽  
Neurological Impairment ◽  
Emergency Department Visits ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Increased Risk ◽  
Ed Visits

Background: The long-term prognosis of spontaneous intracerebral hemorrhage (SICH) is poor. Frequent emergency department (ED) visits can signal increased risk of hospitalization and death. There are no studies describing the risk of frequent ED visits after SICH. Methods: Retrospective cohort study of a community representative consecutive SICH survivors (2009-2015) from southern Portugal. Logistic regression analysis was performed to identify sociodemographic and clinical factors associated with frequent ED visits (≥4 visits) within the first year after hospital discharge. Results: A total of 360 SICH survivors were identified, 358 (98.6%) of whom were followed. The median age was 72; 64% were males. The majority of survivors (n = 194, 54.2%) had at least 1 ED visit. Reasons for ED visits included infections, falls with trauma, and isolated neurological symptoms. Forty-four (12.3%) SICH survivors became frequent ED visitors. Frequent ED visitors were older and had more hospitalizations ( P < .001) and ED visits ( P < .001) prior to the SICH, unhealthy alcohol use ( P = .049), longer period of index SICH hospitalization ( P = .032), pneumonia during hospitalization ( P = .001), and severe neurological impairment at discharge ( P = .001). Pneumonia during index hospitalization (odds ratio [OR]: 3.08; confidence interval [CI]: 1.39-6.76; P = .005) and history of ED visits prior to SICH (OR: 1.64; CI: 1.19-2.26, P = .003) increased the likelihood of becoming a frequent ED visitor. Conclusions: Predictors of frequent ED visits are identifiable at hospital discharge and during any ED visit. Improvement of transitional care and identification of at-risk patients may help reduce multiple ED visits.

The Role of Ultrasound-Guided Therapeutic Paracentesis in an Outpatient Transitional Care Program: A Case Series

2018 ◽  
Vol 35 (9) ◽  
pp. 1256-1260 ◽  
Author(s):  
Jeffrey Wang ◽  
Shahida Khan ◽  
Paige Wyer ◽  
Jessica Vanderwilp ◽  
Justin Reynolds ◽  
...  
Keyword(s):  
Transitional Care ◽  
Effective Means ◽  
Case Series ◽  
Care Program ◽  
Cost Effective ◽  
Refractory Ascites ◽  
Ultrasound Guided ◽  
Care Clinic ◽  
Wide Range ◽  
Ed Visits

Background: Patients with ascites suffer from distressing symptoms and are at high risk for readmission after hospitalization. Timely paracentesis is an important palliative tool in managing this vulnerable population. At our institution, we have developed a multidisciplinary transitional care program for patients discharged from the hospital with a wide range of complex conditions including refractory ascites. Methods: We present a case series of 10 patients with symptomatic ascites who were enrolled in our transitional care program and treated with ultrasound-guided therapeutic paracentesis in our clinic. Patient medical records were retrospectively reviewed to collect procedure details, outcomes, and follow-up data on emergency department (ED) visits and readmissions. Cost data were obtained from the hospital financial system. Results: Over the span of 9 months (September 2016 to July 2017), 22 total therapeutic paracenteses were performed on 10 unique patients in the transitional care clinic. Median age of the patient cohort was 52.5 years (range: 27-71 years). All patients reported immediate relief of ascites-related discomfort following the procedure. We did not observe any major adverse effects due to the in-clinic procedure. Nine of the 10 patients did not have any ED visits or readmissions within 30 days of discharge. The cost of performing ultrasound-guided paracentesis in the transitional care clinic was US$546.77 compared to US$978.32 when performed in the hospital. Conclusion: Our experience suggests that outpatient paracentesis may be a safe, feasible, and cost-effective means of providing symptom management for patients with ascites during their transition from hospital to home.

scholarly journals Experiences of frail older cardiac patients with a nurse-coordinated transitional care intervention - a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Jepma ◽  
Corine H. M. Latour ◽  
Iris H. J. ten Barge ◽  
Lotte Verweij ◽  
Ron J. G. Peters ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Transitional Care ◽  
Living Arrangement ◽  
Intervention Group ◽  
Adverse Outcomes ◽  
Cardiac Patients ◽  
Added Value ◽  
Structured Interviews ◽  
Post Discharge ◽  
Care Intervention

Abstract Background Older cardiac patients are at high risk of readmission and mortality. Transitional care interventions (TCIs) might contribute to the prevention of adverse outcomes. The Cardiac Care Bridge program was a randomized nurse-coordinated TCI combining case management, disease management and home-based rehabilitation for hospitalized frail older cardiac patients. This qualitative study explored the experiences of patients’ participating in this study, as part of a larger process evaluation as this might support interpretation of the neutral study outcomes. In addition, understanding these experiences could contribute to the design and application of future transitional care interventions for frail older cardiac patients. Methods A generic qualitative approach was used. Semi-structured interviews were performed with 16 patients ≥70 years who participated in the intervention group. Participants were selected by gender, diagnosis, living arrangement and hospital of inclusion. Data were analysed using thematic analysis. In addition, quantitative data about intervention delivery were analysed. Results Three themes emerged from the data: 1) appreciation of care continuity; 2) varying experiences with recovery and, 3) the influence of an existing care network. Participants felt supported by the transitional care intervention as they experienced post-discharge support and continuity of care. The perceived contribution of the program in participants’ recovery varied. Some participants reported physical improvements while others felt impeded by comorbidities or frailty. The home visits by the community nurse were appreciated, although some participants did not recognize the added value. Participants with an existing healthcare provider network preferred to consult these providers instead of the providers who were involved in the transitional care intervention. Conclusion Our results contribute to an explanation of the neutral study of a nurse-coordinated transitional care intervention. For future purpose, it is important to identify which patients might benefit most from TCIs. Furthermore, the intensity and content of TCIs could be more personalized by tailoring interventions to older cardiac patients’ needs, considering their frailty, self-management skills and existing formal and informal caregiver networks.

Abstract 357: Effect of an Early Nurse Practitioner Based Transitional Care Program on Atrial Fibrillation Readmissions

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Redah Z Mahmood ◽  
Sherry M Bumpus ◽  
Daniel G Montgomery ◽  
Eva Kline-Rogers ◽  
James B Froehlich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nurse Practitioner ◽  
Transitional Care ◽  
Tertiary Care ◽  
Care Program ◽  
Discharge Diagnosis ◽  
Chart Audit ◽  
Care Clinic ◽  
Coronary Syndrome ◽  
Ed Visits

Background: BRIDGE is a nurse practitioner (NP) based transitional care program for cardiac patients(pts) discharged from a large tertiary care health system. Attendance at the BRIDGE clinic has been shown to reduce early readmission and ED visits for acute coronary syndrome (ACS) pts. Little is known about causes of readmission for atrial fibrillation (AF) pts and whether an NP based program affects overall readmissions. Methods: Retrospective data on 1188 pts was abstracted from 2008 to 2010 for pts referred to BRIDGE. Early (30 day) readmission of pts with discharge diagnosis of AF underwent qualitative chart audit by a trained MD abstractor. When examining if BRIDGE affected readmissions, we excluded pts with ED visits/readmits prior to BRIDGE. Results: Median time to BRIDGE was 16 days. Of 1010 with complete data, 148 (15%) had a discharge diagnosis of AF; 110/148 (74%) AF pts attended BRIDGE. Thirty day readmission (30DR) for AF was 23% (34/148); 17/34 (57%) were sent to the ED by a MD or nurse. Attending BRIDGE had no effect on outcomes at all time points (table 1); 17 patients were readmitted before BRIDGE. Readmission at 6 months for AF was 41% for those who attended BRIDGE, 29% for those who did not (p=0.190). Table 2 details reasons for all 30DR in AF pts. Chart review demonstrated that all 30DR were appropriate, 83% (25/30) of non-elective readmissions were unavoidable, and of 5 potentially avoidable readmissions, 2 were due to patient non-compliance. Conclusions: 30-day readmission rates are high for pts recently discharged with a diagnosis of AF and most are unavoidable. A NP based transitional care clinic successful in reducing 30 day readmissions for ACS pts did not prevent either early or late readmissions in AF pts.

Abstract 095: Lessons Learned from the BRIDGE Registry: Major Findings From 8 Years of BRIDGE

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Morgan Bradford ◽  
Rachel Krallman ◽  
Colin McMahon ◽  
Daniel Montgomery ◽  
Eva Kline-Rogers ◽  
...  
Keyword(s):  
Transitional Care ◽  
The United States ◽  
Lessons Learned ◽  
Unplanned Readmission ◽  
Post Discharge ◽  
Care Clinic ◽  
Coronary Syndrome ◽  
Patient Reported ◽  
Comorbidity Scores

Background: Readmissions after cardiac hospitalizations are frequent and costly in the United States. Delays in follow-up and lack of adherence to guidelines may contribute to high unplanned readmission rates. Bridging the Discharge Gap Effectively (BRIDGE) is a nurse practitioner (NP) led, transitional care clinic for cardiac patients, aimed at reducing readmissions. Data on patients referred to BRIDGE has been collected since 2009; herein we report a summary of significant findings from these data. Methods: A qualitative review of results and conclusions from all published abstracts, oral presentations, and papers from the BRIDGE registry (June 2008-August 2015) was conducted. Content analysis was used to synthesize findings across studies. Results: Data from 3982 patients referred to BRIDGE have been collected. Seven themes were identified in the analysis of BRIDGE publications. During BRIDGE, NPs focused on medical history, symptoms, medication management (in 24.8% of visits), patient education, and referrals. In addition to addressing provider priorities, addressing patient concerns (daily living and clinical questions, feelings and fears) was highly salient, resulting in a high level of patient-NP connectedness as evidenced by high patient-reported scores on the Consultation and Relational Empathy scale (mean 43.5 ± 2.8; possible range 0, 50) and the Patient-Doctor Relationship Questionnaire (mean 43.05 ± 3.1; possible range 5, 45). Readmissions within 30 days were consistently lower for acute coronary syndrome (ACS) patients who attended BRIDGE compared to those who did not (6.4% v. 13.1%; p<0.01); similar results were not seen in heart failure (HF) (15.4% v. 15.7%; p=0.944) or atrial fibrillation (AF) (8.5% v. 5.2%; p=0.343) patients. A spike in HF readmissions was seen between 8-14 days post-discharge, suggesting the need for a sooner appointment. However, follow-up within 7 days of discharge did not show reduced readmissions in HF patients. AF readmissions were also difficult to avoid; in a subset of AF patients readmitted within 30 days, 51.1% (n=23) were readmitted for non-AF diagnoses. High risk patients (i.e. those with an adverse event before BRIDGE) were older, had higher Charlson comorbidity scores, and were more likely to have depression. However, marriage was associated with fewer readmissions. Conclusions: Data from the BRIDGE registry have shown that clinic attendance reduced ACS readmissions; has characterized older, depressed patients with higher Charlson comorbidity scores as being those most likely to be readmitted; and has identified areas for improvement in transitional care (e.g. AF and HF) where readmissions are difficult to avoid. Continuous quality improvement and real-time monitoring of patient outcomes have translated this research into more prompt transitional care, illustrating the importance of registry-based research.

Abstract 313: Investigation of Substance Use in the Bridge Population

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Rossteen Abbasi ◽  
Rachel H Krallman ◽  
Delaney Feldeisen ◽  
Daniel G Montgomery ◽  
Eva M Kline-Rogers ◽  
...  
Keyword(s):  
Substance Use ◽  
Transitional Care ◽  
Substance Users ◽  
Care Clinic ◽  
Illicit Substance ◽  
Comorbidity Scores ◽  
History Of ◽  
Ed Visits ◽  
Alcohol Users ◽  
The Impact

Background: Alcohol and drug dependence has been linked to increased readmissions and ED visits in some populations. This study investigated the impact of different substance use (SU) on outcomes (ED visit, readmission, death) among hospitalized cardiac patients (pts). Methods: Data on all pts referred to the BRIDGE cardiac transitional care clinic from 2008-2017 were collected. Chart review was conducted on a random selection of pts with a history of SU (n=152) to determine the type of substance used: alcohol, tobacco, illicit substances (i.e. cocaine, narcotics, marijuana) (study conducted prior to Michigan’s legalization of marijuana), or multiple substances. Demographics and outcomes at 30 and 180 days were compared between SU groups. Results: Of 3536 pts, 305 (8.6%) had a history of SU. Compared to those without SU, SU pts were younger (57.3±13.2 v 66.7±14.5 years, p<0.001), male (72.8% v 62.1%, p<0.001), single (62.5% v 38.0%, p<0.001), non-white (21.9% v 15.6%, p=0.005), less likely to attend their BRIDGE appointment (35.7% v 28.3%, p=0.012), had lower Charlson comorbidity scores (CCS) (3.7 v 4.9, p<0.001), and were more likely to visit the ED within 180 days of discharge (44.4% v 38.1%, p=0.033). Of 152 randomly selected SU pts, 57 (37.5%) used alcohol, 20 (13.2%) tobacco, 28 (18.4%) illicit, and 47 (30.9%) multiple substances. Illicit substance users were more likely to be from low SES communities. Despite older age and higher CCS than the other SU groups, alcohol users had fewer 180 day ED visits (p=0.007) and 180 day readmissions (p=0.024) than illicit substance users, as well as fewer 180 day readmissions (p=0.044) than multiple substance users. Conclusion: Compared to the national average (US Department of Health and Human Services), pts referred to BRIDGE appear more likely to have a history of SU (6.4% v 8.6%). Despite being younger and having lower comorbid burden, SU pts in this population had worse outcomes, as seen in prior studies. Additionally, they were less likely to attend a transitional care appointment, putting them at greater risk. Alcohol users, while older and sicker, had the best outcomes among SU pts; illicit substance users had the worst. Further research to identify the causes of these ED visits and readmissions, as well as targeted strategies to improve outcomes in this population are warranted.

Abstract 305: Characteristics of Heart Failure Patients Referred to the Bridge Transitional Care Clinic By Time to Readmission

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
George Cholack ◽  
Joshua Garfein ◽  
Rachel H Krallman ◽  
Delaney Feldeisen ◽  
Kim Eagle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Characteristics ◽  
Transitional Care ◽  
Discharge Planning ◽  
Nyha Class ◽  
Index Admission ◽  
Post Discharge ◽  
Care Clinic ◽  
Early Readmission

Background: Readmission reduction initiatives emphasize prompt follow-up post-discharge. Identifying factors that influence early readmission may inform discharge planning. We compared characteristics of heart failure (HF) patients (pts) based on time to readmission to determine which pt characteristics were associated with early readmission. Methods: Pts referred to the BRIDGE clinic following index admission for HF from 2008-2017 were eligible. Demographics and inpatient clinical characteristics were compared between 1) pts who were and were not readmitted within 30 days post-index discharge, and 2) pts who were readmitted early (0-7 days post-discharge) versus late (8-30 days post-discharge). Results: Of 978 HF pts, 226 (23.1%) were readmitted within 30 days. Compared to those not readmitted, 30-day readmits were more likely to be male, white, and have higher NYHA class, longer index stay, ICU admission during index admission, and lower Hgb, higher Cr, and higher BUN during index admission. Among those with a 30 day readmit, 56 (24.8%) were readmitted within 7 days of discharge. Early readmits were more often female (p=0.07) and had index stays in the ICU (p=0.07). Conclusion: Pts readmitted within 30 days had more complicated hospital courses than those not readmitted, and those readmitted early had higher incidences of females and index stays in the ICU. Efforts to define a high risk subset of HF pts likely to be readmitted early and targeting them for enhanced discharge planning is warranted.

Sign in / Sign up

Export Citation Format

Share Document