Early readmission for heart failure: An avoidable or ineluctable debacle?

Alberto Palazzuoli, Isabella Evangelista, Gaetano Ruocco, Carlo Lombardi, Valtere Giovannini, Ranuccio Nuti, Stefano Ghio, Giuseppe Ambrosio

Research output: Contribution to journalArticlepeer-review

Abstract

Early hospital readmission after an episode of Acute Decompensated Heart Failure (ADHF) is an emerging issue that is causing a relevant clinical and economic burden. Although there might be several reasons for early readmissions, in many cases these might be effectively prevented by a more adequate post-discharge management, including recommendations on lifestyle and rehabilitation programs. However, almost half of hospitalizations are unrelated to specific cardiac causes and thus increases the difficulty in analyzing risks prediction. Many episodes are related to social environment, poor familiar assistance and inadequate followup program. In addition, the national and insurance companies constantly quest for a reduction of costs that could lead to inappropriately shortened hospital stays. Therefore, the suitability of early re-hospitalization as a correct target for good medical practice is highly debated. Nevertheless, the post-discharge phase after episodes of ADHF remains poorly analyzed in clinical trials and specific investigations should be considered during the transition period from acute to chronic status. A validated program, which focuses on an appropriate risk algorithm including cardiac and extracardiac precipitating factors is lacking. This is a necessary and it should become one of the most important targets to aim for in HF management and strategy.
Original languageEnglish
Pages (from-to)186-195
Number of pages10
JournalInternational Journal of Cardiology
Volume277
DOIs
Publication statusPublished - Feb 15 2019

Keywords

  • Acute heart failure
  • Follow-up
  • Hospitalization
  • Outcome
  • Treatment
  • Age Factors
  • Continental Population Groups
  • Follow-Up Studies
  • Heart Failure/diagnosis/*epidemiology/*therapy
  • Humans
  • Patient Readmission/*trends
  • Risk Factors
  • Sex Factors
  • Time Factors

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