Observation of Patients Transitioned to an Oral Loop Diuretic Before Discharge and Risk of Readmission for Acute Decompensated Heart Failure.

Abstract

BACKGROUND:

Heart failure (HF) is associated with high 30-day readmission rates and places significant financial burden on the health care system. The aim of this study was to determine if the duration of observation on an oral loop diuretic before discharge is associated with a reduction in 30-day HF readmission in patients with acute decompensated HF (ADHF).

METHODS AND RESULTS:

This was a retrospective study of adult patients admitted for ADHF at a large academic medical center. A total of 123 patients were included. Baseline characteristics were similar between groups. The primary outcome of 30-day HF readmission occurred in 11 of 61 patients (18%) observed on an oral loop diuretic for <24 hours and in 2 of 62 patients (3.2%) observed on an oral loop diuretic for ≥24 hours (P = .023). Readmissions for 60- and 90-day HF were also significantly lower in patients observed for ≥24 hours (P = .014 and P = .049, respectively). Associations became stronger after multivariate analysis (P < .001). Observation for <24 hours and previous admission within 30 days were independent predictors of 30-day HF readmission (P = .03).

CONCLUSIONS:

Observation of patients on an oral loop diuretic for <24 hours was associated with significantly higher 30-day HF readmission. Therefore, observation on an oral loop diuretic for ≥24 hours before discharge in patients presenting with ADHF should be strongly considered.

• Authors: Benjamin Laliberte, Brent N Reed, Sandeep Devabhakthuni, Kristin Watson, Vijay Ivaturi, Tao Liu, Stephen S Gottlieb
• Journal: Journal of cardiac failure (J Card Fail) Vol. 23 Issue 10 Pg. 746-752 (Oct 2017) ISSN: 1532-8414 [Electronic] United States
• PMID: 28688888 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• Sodium Potassium Chloride Symporter Inhibitors

Topics

• Acute Disease
• Administration, Oral
• Adult
• Aged
• Female
• Follow-Up Studies
• Heart Failure (diagnosis, drug therapy, mortality)
• Humans
• Male
• Middle Aged
• Mortality (trends)
• Patient Discharge (trends)
• Patient Readmission (trends)
• Prospective Studies
• Retrospective Studies
• Risk Factors
• Sodium Potassium Chloride Symporter Inhibitors (administration & dosage)