Heart Failure Patients Readmitted to Same Hospital May Fare Better

Heart failure patients readmitted to the same hospital within a month are discharged quicker and more likely to survive, according to a new Canadian study.

Among 217,039 heart failure patients in Canada from 2004 to 2013, those readmitted to the same hospital were discharged an average one day sooner and were 11 percent less likely to die during their hospitalization.

Researchers also found that 18.1 percent were readmitted within 30 days — 83.2 percent to the original hospital and 16.8 percent to a different hospital. The most common cause for readmission was heart failure (36.9 percent).

“For the individual patient, these differences may not seem like much, but considering that heart failure is one of the most common reasons for hospitalization and readmission in North America, it’s a big issue for the healthcare system,” said Finlay A. McAlister, M.D., the study’s lead researcher and professor of general internal medicine at the University of Alberta in Edmonton, Canada.

In Canada and the United States, ambulance policies usually require patients be taken to the nearest emergency room, even if a patient has recently been hospitalized somewhere else.

“This makes sense in time-sensitive acute conditions where delays in initial treatment are associated with poorer outcomes — thus the adage ‘time is muscle’ for heart attacks and ‘time is brain’ for strokes,” McAlister said.

About 6.5 million U.S. adults live with heart failure, which occurs when the heart muscle is too weak to pump sufficient blood to vital organs throughout the body.

Although Canada has free universal access to hospital care, the study findings are likely to also apply to the United State because of similar rates of readmission for heart failure and similar gaps in the transfer of medical information from one facility to another, researchers said.

By 2030, the prevalence of heart failure will increase 46 percent compared with 2012, according to American Heart Association statistics.

“Patients’ hospital records may not be completed for weeks and they don’t report all of the things that happened during the initial hospitalization,” McAlister said. “For example, it is not uncommon for heart failure patients to not tolerate or have adverse responses to higher doses of some guideline-recommended medications. That information rarely appears on discharge summaries, so patients are at risk of the same thing happening if they are admitted to a different hospital.

“If you are discharged from the hospital after heart failure, book a follow-up appointment with your physician within two weeks of discharge. If your condition deteriorates, try to see a familiar physician as soon as possible,” he said.

The study is published in the Journal of the American Heart Association.

For more about heart failure, see our award-winning Heart Insight Special Topic Supplement.

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