2017 Resarch Forum

IM: M-1

Applicant & Principal Investigator: Ali Ammar MD

Discharge hypertension as a predictor of 90 day readmission in heart failure patients with reduced ejection fraction Ali Ammar MD, Jeffrey Coleman MS IV , Saman Ratnayake, MD

INTRODUCTION Heart failure (HF) is a serious, chronic, and progressive condition that may require hospitalization if decompensated. Each year, in the United States there are approximately 1 million hospitalizations due to decompensated HF, which costs approximately $39 billion annually. PURPOSE The objective of this study was to describe the frequency of hospital readmissions for patients with HF with respect to their blood pressure on discharge. METHODS In this retrospective study, 400 patients were identified with study criteria of age ≥ 65, low left ventricular ejection fraction (LVEF) defined as < 40% and either high or normal blood pressure on discharge . 200 patients with high blood pressure defined as systolic blood pressure > 160 mmHg and/or diastolic blood pressure >100mmHg on discharge were identified (July, 2015 to July, 2016). Data was collected through uniform query of a community hospital database. Data were collected on patient demographics, medical history, laboratory findings, antihypertensive therapies, hospital associated events, readmission within 90 days of hospital discharge, and admission to ICU within 90 days, following the index hospitalization. DISCUSSION The 90-day readmission rate of HF patients discharged with high blood pressure was 36% (72/200). Of those patients 33% (24/72) were readmitted more than once. Conversely, only 14% (28/200) of HF patients discharged with systolic blood pressure less than 160 required readmission. Of those patients 7% (2/28) were readmitted more than once. Patients discharged with systolic blood pressure >160 had a significantly greater overall readmission rate with p value of 0.0278. CONCLUSION Blood pressure control on discharge is important to decrease readmission.