Vinson et al identified risk factors associated with readmission for congestive heart failure in elderly patients. These factors can help identify a patient who may require closer monitoring or more aggressive management. The authors are from Jewish Hospital and Washington University Medical Center in St. Louis, Missouri.


Patient selection:

(1) age >= 70 years of age

(2) hospitalized for congestive heart failure


Risk factors for readmission within 90 days of discharge:

(1) prior history of heart failure (previous to current admission)

(2) >= 4 admissions within the previous 8 years

(3) heart failure precipitated by acute myocardial infarction

(4) heart failure precipitated by uncontrolled hypertension (> 180/100)


Preventable or remediable risk factors associated with early readmission:

(1) noncompliance with medications

(2) nonadherence with diet

(3) inadequate discharge planning (failure to involve social services and other ancillary support staff)

(4) inadequate followup (failure to involve home care or a prolonged interval to next appointment with the physician)

(5) failure in the social support system (failure in active family involvement)

(6) failure to seek medical attention promptly upon symptom recurrence


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