Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.

Many quality-of-care and risk prediction metrics rely on time to first rehospitalization even though heart failure (HF) patients may undergo several repeat hospitalizations. The aim of this study is to compare repeat hospitalization models. Using a population-based cohort of 40,667 patients, we exam...

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Autores principales:	Jeffrey A Bakal, Finlay A McAlister, Wei Liu, Justin A Ezekowitz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0071a11adfbc435ebaabc5c10ed50ff5
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spelling	oai:doaj.org-article:0071a11adfbc435ebaabc5c10ed50ff52021-11-25T06:00:59ZHeart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.1932-620310.1371/journal.pone.0106494https://doaj.org/article/0071a11adfbc435ebaabc5c10ed50ff52014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0106494https://doaj.org/toc/1932-6203Many quality-of-care and risk prediction metrics rely on time to first rehospitalization even though heart failure (HF) patients may undergo several repeat hospitalizations. The aim of this study is to compare repeat hospitalization models. Using a population-based cohort of 40,667 patients, we examined both HF and all cause re-hospitalizations using up to five years of follow-up. Two models were examined: the gap-time model which estimates the adjusted time between hospitalizations and a multistate model which considered patients to be in one of four states; community-dwelling, in hospital for HF, in hospital for any reason, or dead. The transition probabilities and times were then modeled using patient characteristics and number of repeat hospitalizations. We found that during the five years of follow-up roughly half of the patients returned for a subsequent hospitalization for each repeat hospitalization. Additionally, we noted that the unadjusted time between hospitalizations was reduced ∼40% between each successive hospitalization. After adjustment each additional hospitalization was associated with a 28 day (95% CI: 22-35) reduction in time spent out of hospital. A similar pattern was seen when considering the four state model. A large proportion of patients had multiple repeat hospitalizations. Extending the gap between hospitalizations should be an important goal of treatment evaluation.Jeffrey A BakalFinlay A McAlisterWei LiuJustin A EzekowitzPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e106494 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jeffrey A Bakal Finlay A McAlister Wei Liu Justin A Ezekowitz Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
description	Many quality-of-care and risk prediction metrics rely on time to first rehospitalization even though heart failure (HF) patients may undergo several repeat hospitalizations. The aim of this study is to compare repeat hospitalization models. Using a population-based cohort of 40,667 patients, we examined both HF and all cause re-hospitalizations using up to five years of follow-up. Two models were examined: the gap-time model which estimates the adjusted time between hospitalizations and a multistate model which considered patients to be in one of four states; community-dwelling, in hospital for HF, in hospital for any reason, or dead. The transition probabilities and times were then modeled using patient characteristics and number of repeat hospitalizations. We found that during the five years of follow-up roughly half of the patients returned for a subsequent hospitalization for each repeat hospitalization. Additionally, we noted that the unadjusted time between hospitalizations was reduced ∼40% between each successive hospitalization. After adjustment each additional hospitalization was associated with a 28 day (95% CI: 22-35) reduction in time spent out of hospital. A similar pattern was seen when considering the four state model. A large proportion of patients had multiple repeat hospitalizations. Extending the gap between hospitalizations should be an important goal of treatment evaluation.
format	article
author	Jeffrey A Bakal Finlay A McAlister Wei Liu Justin A Ezekowitz
author_facet	Jeffrey A Bakal Finlay A McAlister Wei Liu Justin A Ezekowitz
author_sort	Jeffrey A Bakal
title	Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
title_short	Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
title_full	Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
title_fullStr	Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
title_full_unstemmed	Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
title_sort	heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/0071a11adfbc435ebaabc5c10ed50ff5
work_keys_str_mv	AT jeffreyabakal heartfailurereadmissionmeasuringtheevershorteninggapbetweenrepeatheartfailurehospitalizations AT finlayamcalister heartfailurereadmissionmeasuringtheevershorteninggapbetweenrepeatheartfailurehospitalizations AT weiliu heartfailurereadmissionmeasuringtheevershorteninggapbetweenrepeatheartfailurehospitalizations AT justinaezekowitz heartfailurereadmissionmeasuringtheevershorteninggapbetweenrepeatheartfailurehospitalizations
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Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.

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