Do-not-resuscitate orders and readmission among elderly patients with heart failure in Pennsylvania: An observational study, 2011 - 2014.
Do-not-resuscitate
Heart failure
Readmission
Journal
Heart & lung : the journal of critical care
ISSN: 1527-3288
Titre abrégé: Heart Lung
Pays: United States
ID NLM: 0330057
Informations de publication
Date de publication:
Historique:
received:
25
05
2020
revised:
03
09
2020
accepted:
09
09
2020
pubmed:
4
10
2020
medline:
5
3
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
Readmissions for patients with heart failure (HF) continues to be a target of value-based purchasing initiatives. Do-not-resuscitate (DNR) orders-one part of advance care planning (ACP)-have been shown to be related to other patient outcomes but has not been explored as a risk factor for HF readmission. Examine the association between DNR and 30-day readmissions among elderly patients with HF admitted to hospitals in Pennsylvania. Data included hospital discharges from 2011 to 2014 of patients 65+ years with a primary diagnosis of HF. Logistic regression was used to model the relationship between DNR and 30-day readmission. Among 107,806 patients, 20.9% were readmitted within 30 days. After controlling for covariates, patients with HF who had a DNR were less likely to be readmitted to the hospital (OR=0.85, 95% CI: 0.80-0.91, p<0.001). Documentation of a DNR may inform efforts to reduce readmissions among elderly patients with HF.
Sections du résumé
BACKGROUND
Readmissions for patients with heart failure (HF) continues to be a target of value-based purchasing initiatives. Do-not-resuscitate (DNR) orders-one part of advance care planning (ACP)-have been shown to be related to other patient outcomes but has not been explored as a risk factor for HF readmission.
OBJECTIVES
Examine the association between DNR and 30-day readmissions among elderly patients with HF admitted to hospitals in Pennsylvania.
METHODS
Data included hospital discharges from 2011 to 2014 of patients 65+ years with a primary diagnosis of HF. Logistic regression was used to model the relationship between DNR and 30-day readmission.
RESULTS
Among 107,806 patients, 20.9% were readmitted within 30 days. After controlling for covariates, patients with HF who had a DNR were less likely to be readmitted to the hospital (OR=0.85, 95% CI: 0.80-0.91, p<0.001).
CONCLUSIONS
Documentation of a DNR may inform efforts to reduce readmissions among elderly patients with HF.
Identifiants
pubmed: 33010520
pii: S0147-9563(20)30375-7
doi: 10.1016/j.hrtlng.2020.09.012
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
812-816Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.