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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Recurrent Acute Decompensated Heart Failure Admissions for Patients With Reduced Versus Preserved Ejection Fraction
Melissa C Caughey1, Carla A Sueta1, Sally C Stearns2
1Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
The American Journal of Cardiology
|April 29, 2018
Summary
Patients with heart failure with reduced ejection fraction (HFrEF) experience more frequent hospital readmissions for acute decompensated heart failure (ADHF) compared to those with preserved ejection fraction (HFpEF). This increased burden of readmissions is evident in both short-term and long-term follow-up periods.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Hospitals must report all-cause 30-day heart failure readmissions.
- Same-cause readmissions for heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF) are less understood.
- The ARIC study has tracked patients hospitalized with acute decompensated heart failure (ADHF) since 2005.
Purpose of the Study:
- To compare same-cause readmission rates for HFrEF versus HFpEF.
- To analyze readmission patterns at various time points (30 days, 90 days, 6 months, 1 year).
- To identify differences in readmission burden between HFrEF and HFpEF patients.
Main Methods:
- Analysis of medical records for 1,133 cohort members hospitalized with ADHF (2005-2014).
- HFrEF defined by ejection fraction <50%; physician validation of ADHF.
- Repeat-measures Cox regression models used to analyze all recurrent ADHF admissions per patient.
Main Results:
- Half of the study cohort had HFpEF; these patients were more often women with more comorbidities.
- Overall ADHF readmission rates were highest within 30 days.
- HFrEF patients showed a trend for higher adjusted ADHF readmissions at 30 days (HR 1.41), 90 days (HR 1.39), 6 months (HR 1.47), and 1 year (HR 1.42) compared to HFpEF patients.
Conclusions:
- Patients with HFrEF face a greater burden of short- and long-term readmissions for recurrent ADHF.
- Understanding these differences is crucial for targeted interventions and resource allocation.
- Further research may explore specific drivers of readmission in HFrEF versus HFpEF.
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