Thirty-Day Readmission Risk Among Adults Hospitalized for Heart Failure or Acute Myocardial Infarction With and...

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• People with HIV (PWH) exhibit increased incidence of heart failure (HF) and acute myocardial infarction (AMI) compared to people without HIV (PWoH).
• Hospital readmission rates serve as a key quality-of-care metric, yet readmission risks for HF or AMI stratified by HIV status are not well-defined.

Purpose of the Study:

• To evaluate 30-day unplanned hospital readmission risks for heart failure (HF) and acute myocardial infarction (AMI) among people with HIV (PWH) compared to people without HIV (PWoH).
• To analyze trends in readmission risk from 2016 to 2022 and examine subgroup-specific risks in 2022 based on HIV status.

Main Methods:

• Utilized the 2016-2022 Nationwide Readmissions Database, including adult hospitalizations for HF or AMI.
• Calculated crude and age-/sex-adjusted risk ratios (aRR) for 30-day all-cause unplanned readmissions using mixed-effects logistic regressions.
• Examined trends and subgroup-specific readmission risks stratified by HIV status.

Main Results:

• From 2016-2022, 30-day readmission risk declined for PWH with HF (39.5% to 33.0%), PWoH with HF (22.9% to 21.6%), and PWH with AMI (19.3% to 16.8%).
• In 2022, PWH showed significantly higher readmission risk than PWoH for both HF (aRR=1.46) and AMI (aRR=1.59).
• Common readmission diagnoses for both groups included hypertensive heart disease with CKD for HF and recurrent AMI for AMI. Higher risks for PWH were observed across age and sex strata, particularly in younger males and older females.

Conclusions:

• People with HIV (PWH) experience significantly higher 30-day readmission rates following hospitalization for heart failure (HF) and acute myocardial infarction (AMI).
• Targeted interventions, including enhanced follow-up care and multidisciplinary management, are essential to mitigate elevated readmission risks in PWH.