Research in Brief: Clinical Characteristics of Hospital Readmission

SEPTEMBER 27, 2013 - Kelley Anderson, PhD, RN, FNP, assistant professor of nursing at the School of Nursing & Health Studies, authored a recent manuscript on hospital readmission among patients with heart failure (HF).

The article, “Discharge Clinical Characteristics and 60-Day Readmission in Patients Hospitalized With Heart Failure,” appeared in the Journal of Cardiovascular Nursing.

Repeat Hospitalizations

“Heart failure is a clinical syndrome that incurs a high prevalence, mortality, morbidity, and economic burden in our society,” Anderson writes.  “Patients with heart failure may experience hospitalization because of an acute exacerbation of their condition.  Recurrent hospitalizations soon after discharge are an unfortunate occurrence in this patient population.”

Anderson set out to understand what clinical characteristics among this patient population at the time of discharge might be related to future readmissions.  Overall, the author retrospectively reviewed the medical records of 134 patients.

Study’s Uniqueness

The study’s key findings, according to the article, are:

  • Three characteristics at discharge – dyspnea (or difficulty breathing), crackles (abnormal breath sounds) and activities of daily living (ADLs) – appear to be significantly related to 60-day readmissions for heart failure patients.
  • Hospital readmission could be predicted for more than 75 percent of the 134 patients based on evaluation of these three characteristics at the time of discharge.
  • These characteristics are more important for predicting future readmission than other factors, including – but not limited to – gender, age, ethnicity, brain natriuretic peptide, left ventricular ejection fraction, and blood pressure.

“This study is unique in demonstrating that unresolved clinical factors and symptoms at the end of hospitalization result in the strongest predictors for HF rehospitalization in this cohort of patients,” Anderson writes.

More Information

Anderson notes that the study had a few limitations, such as sample size, the retrospective review, and controlling for the number of factors that might contribute to readmission in this complex patient population.  For more information, click here.

By Bill Cessato