TY - JOUR
T1 - Risk factors of readmission to acute care hospital among individuals with heart failure and left ventricular assist device (LVAD) at inpatient rehabilitation setting (STROBE compliant article)
AU - Kim, Yong Kyun
AU - Balcetis, Nomeda
AU - Novitch, Richard
AU - Oh-Park, Mooyeon
N1 - Publisher Copyright:
Copyright © 2020 the Author(s).
PY - 2020/12/24
Y1 - 2020/12/24
N2 - In post-acute care hospital setting, the heart failure (HF) individuals with left ventricular assist device (LVAD) have about 30% of transfer to acute care hospitals which requires readmission. There is relative increase in cost and mortality due to the readmission. The goal of this study is to identify possible risk factors at Inpatient Rehabilitation Unit (IRU) to decrease the rate of readmission to acute care hospitals. This study is retrospective study at the Inpatient Rehabilitation Unit (IRU) Twenty one individuals with HF and LVAD were admitted to IRU. We determined 2 subgroups. One is the readmission group (Readmission) and the other is the control group (Control). Readmission (n=6) is the individuals who were transferred to acute care hospital, and Control (n=15) is the individuals who were discharged. To compare Readmission group with Control group and evaluate demographic, laboratory, and functional outcome parameters. Main Outcome Measures are Body Mass Index (BMI), International Normalized Ratio (INR), and Functional independence measure (FIM). At admission, INR in Readmission group was 3.4±1.2 and in Control group was 2.2±0.5 with a statistically significant p value (P=.004) and FIM score in Readmission group was 81.2±15.9 and in Control group was 96.3±11.5 with a statistically significant p value (P=.023). The study showed the individuals with HF and LVAD at IRU had high INR and low FIM which may be the cause for readmission and need more attentive care. This data can help identify the factors causing readmission and help reduce the rate of readmission. Further evaluation is necessary to determine the cause for readmission. Abbreviations: ACC = American college of cardiology, ACH = acute care hospital, AHA = American heart association, AICD = automated implantable cardioverter defibrillator, BMI = body mass index, BUN = blood urea nitrogen, CDC = centers for disease control and prevention, CI = confidence interval, DM = diabetes mellitus, FIM = functional independence measure, GI = gastrointestinal, Hb = Hemoglobin, Hct = Hematocrit, HF = heart failure, INR = international normalization ratio, IRB = institutional review board, IRU = inpatient rehabilitation unit, LOS = length of stay, LVAD = left ventricle assist device, MAP = mean arterial pressure, SD = standard deviation, WBC = white blood cell.
AB - In post-acute care hospital setting, the heart failure (HF) individuals with left ventricular assist device (LVAD) have about 30% of transfer to acute care hospitals which requires readmission. There is relative increase in cost and mortality due to the readmission. The goal of this study is to identify possible risk factors at Inpatient Rehabilitation Unit (IRU) to decrease the rate of readmission to acute care hospitals. This study is retrospective study at the Inpatient Rehabilitation Unit (IRU) Twenty one individuals with HF and LVAD were admitted to IRU. We determined 2 subgroups. One is the readmission group (Readmission) and the other is the control group (Control). Readmission (n=6) is the individuals who were transferred to acute care hospital, and Control (n=15) is the individuals who were discharged. To compare Readmission group with Control group and evaluate demographic, laboratory, and functional outcome parameters. Main Outcome Measures are Body Mass Index (BMI), International Normalized Ratio (INR), and Functional independence measure (FIM). At admission, INR in Readmission group was 3.4±1.2 and in Control group was 2.2±0.5 with a statistically significant p value (P=.004) and FIM score in Readmission group was 81.2±15.9 and in Control group was 96.3±11.5 with a statistically significant p value (P=.023). The study showed the individuals with HF and LVAD at IRU had high INR and low FIM which may be the cause for readmission and need more attentive care. This data can help identify the factors causing readmission and help reduce the rate of readmission. Further evaluation is necessary to determine the cause for readmission. Abbreviations: ACC = American college of cardiology, ACH = acute care hospital, AHA = American heart association, AICD = automated implantable cardioverter defibrillator, BMI = body mass index, BUN = blood urea nitrogen, CDC = centers for disease control and prevention, CI = confidence interval, DM = diabetes mellitus, FIM = functional independence measure, GI = gastrointestinal, Hb = Hemoglobin, Hct = Hematocrit, HF = heart failure, INR = international normalization ratio, IRB = institutional review board, IRU = inpatient rehabilitation unit, LOS = length of stay, LVAD = left ventricle assist device, MAP = mean arterial pressure, SD = standard deviation, WBC = white blood cell.
KW - FIM
KW - INR
KW - LVAD
KW - Readmission
KW - Risk factor
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U2 - 10.1097/MD.0000000000023618
DO - 10.1097/MD.0000000000023618
M3 - Article
C2 - 33350737
AN - SCOPUS:85099113766
SN - 0025-7974
VL - 99
JO - Medicine (United States)
JF - Medicine (United States)
IS - 52
M1 - e23618
ER -