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Risk Factors of Krumholz et al for Hospital Readmission in Elderly Patients with Heart Failure

Purpose: To identify recently discharged elderly patients with heart failure who are at high risk for readmission with heart failure or death within 6 months.

Description

Krumholz et al identified risk factors which can help to determine which elderly patients discharged with heart failure are at high risk for readmission or death. These patient may benefit from more aggressive interventions. The study was done in New Haven and Middletown, Connecticut in conjunction with Yale University.


Patient selection:

(1) age >= 65 years of age

(2) heart failure as a principal discharge diagnosis

 

Parameter

Finding

Points

prior admission within past year

no

0

 

yes

1

previous history of heart failure

no

0

 

yes

1

diabetes mellitus

no

0

 

yes

1

serum creatinine at discharge

<= 2.5 mg/dL

0

 

> 2.5 mg/dL

1

 

number of risk factors =

= SUM(points for all 4 risk factors)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

 

Number of Risk Factors

Risk for Readmission within 6 Months of Discharge

Risk for Readmission and/or Death within 6 Months of Discharge

0

26%

31%

1 or 2

48%

54%

3 or 4

59%

65%

 

Limitations:

• Patients with a very low risk for readmission are not identified.


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Specialty

Objective

ICD-10