Thirty-day hospital readmission in females with acute heart failure and breast cancer: A retrospective cohort study from national readmission database

Department

Medicine

Document Type

Article

Publication Title

PloS One

Abstract

BACKGROUND: Breast Cancer and cardiovascular diseases are amongst the two leading causes of mortality in the United States, and the two conditions are connected in part because of recognized cardiotoxicity of cancer treatments. The aim of this study is to investigate the predictors risk factors for thirty-day readmission in female breast cancer survivors presenting with acute heart failure.

METHODS: This is a retrospective cohort study of acute heart failure (AHF) hospitalization in female patients with breast cancer in 2019 using the National Readmission Database (NRD), which is the largest publicly available all-payer inpatient readmission database in the United States. Our study sample included adult female patients aged 18 years and older. The primary outcome of interest was the rate of 30- day readmission.

RESULTS: In 2019, there were 8332 total index admissions for AHF in females with breast cancer and 7776 patients were discharged alive. The mean age was 74.4 years (95% CI: 74, 74.7). The percentage of readmission at 30 days among those discharged alive was 21.8% (n = 1699). Hypertensive heart disease with chronic kidney disease accounted for the majority of readmission in AHF with breast cancer followed by sepsis, acute kidney injury, respiratory failure, pneumonia, and atrial fibrillation. Demographic factors including higher burden of comorbidities predict readmission. The total in-hospital mortality in index admission was 6.67% (n = 556) and for readmitted patients was 8.77% (n = 149). The mean length of stay for index admission was 7.5 days (95% CI: 7.25, 7.75).

CONCLUSIONS: Readmission of female breast cancer survivors presenting with AHF is common and largely be attributed to high burden of comorbidities including hypertension, and chronic kidney disease. A focus on close outpatient follow-up will be beneficial in lowering readmissions.

First Page

e0301596

DOI

10.1371/journal.pone.0301596

Volume

19

Issue

7

Publication Date

7-1-2024

Medical Subject Headings

Humans; Female; Patient Readmission (statistics & numerical data); Heart Failure (epidemiology, mortality); Retrospective Studies; Breast Neoplasms (complications, epidemiology, mortality); Aged; Databases, Factual; Middle Aged; United States (epidemiology); Risk Factors; Acute Disease; Aged, 80 and over; Adult; Comorbidity

PubMed ID

39042606

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