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

People with HIV (PWH) have a higher incidence of heart failure (HF) and acute myocardial infarction (AMI) than people without HIV (PWoH). While hospital readmission is a common quality-of-care indicator, readmission risk for HF or AMI by HIV status is not well defined.

We included adults hospitalized for HF or AMI from the 2016-2022 Nationwide Readmissions Database. The outcome was 30-day all-cause unplanned readmission. We examined trends in readmission risk between 2016 and 2022, and subgroup-specific readmission risk in 2022, by HIV status. Crude and age-and sex-adjusted risk ratios (aRR) were calculated using marginal estimates from mixed-effects logistic regressions.

From 2016 to 2022, 30-day readmission risk significantly declined among PWH hospitalized for HF (39.5%-to-33.0%), PWoH hospitalized for HF (22.9%-to-21.6%), and PWH hospitalized for AMI (19.3%-to-16.8%). In 2022, we included 1 062 309 weighted index hospitalizations for HF and 470 369 for AMI. PWH had significantly higher readmission risk than PWoH for both HF (aRR = 1.46; 95%CI = 1.39-1.53) and AMI (aRR = 1.59; 95%CI = 1.39-1.80). For HF, the most common readmission diagnosis for both PWH and PWoH was hypertensive heart and stages 1-4 chronic kidney disease with HF. For AMI, recurrent unspecified AMI was the most common readmission diagnosis among both PWH and PWoH. In age- and sex-stratified analyses, PWH consistently had higher readmission risk than PWoH for both HF and AMI, with the largest disparities in younger males and older females.

PWH had a significantly higher 30-day readmission risk after HF and AMI hospitalization. Targeted interventions, such as early follow-up and multidisciplinary care, are needed to reduce readmission risks.