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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

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Do-not-resuscitate orders and readmission among elderly patients with heart failure in Pennsylvania: An observational

Katherine Callahan1, Lisa Kitko2, Lauren J Van Scoy3

  • 1Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, 604E Donald H. Ford Building, University Park, PA 16802 United States.

Heart & Lung : the Journal of Critical Care
|October 3, 2020
PubMed

Insights

Patients with heart failure (HF) who have a do-not-resuscitate (DNR) order are less likely to be readmitted within 30 days. This finding can inform strategies to reduce HF readmissions in elderly populations.

Area of Science:

  • Cardiology
  • Geriatrics
  • Health Services Research

Background:

  • Heart failure (HF) readmissions are a focus of healthcare quality initiatives.
  • Advance care planning (ACP), including do-not-resuscitate (DNR) orders, impacts patient outcomes.
  • The link between DNR orders and HF readmission risk is not well-established.

Purpose of the Study:

  • To investigate the association between DNR status and 30-day hospital readmissions.
  • To analyze this relationship in elderly patients (65+ years) with a primary HF diagnosis.
  • To provide data for Pennsylvania hospitals regarding HF readmission factors.

Main Methods:

  • Utilized a dataset of hospital discharges from 2011 to 2014.
  • Included patients aged 65 and older with a primary diagnosis of heart failure.
  • Employed logistic regression to assess the impact of DNR orders on 30-day readmission.

Main Results:

  • Analyzed data from 107,806 patients.
  • Observed a 30-day readmission rate of 20.9%.
  • Found that patients with a DNR order were significantly less likely to be readmitted (OR=0.85, 95% CI: 0.80-0.91, p<0.001) after adjusting for covariates.

Conclusions:

  • DNR documentation is associated with reduced 30-day readmissions for HF patients.
  • This finding suggests DNR status can be a factor in managing HF readmissions.
  • Informing clinicians about this association may aid in reducing readmission rates for elderly HF patients.
Abstract

Keywords:
Do-not-resuscitateHeart failureReadmission

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