Chamberlain RS, et al. - Authors attempted to develop a scale that reliably forecast the readmission rates among patients with chronic heart failure (CHF). A patient’s 30-day CHF readmission risk was reliably predicted by the Readmission After Heart Failure (RAHF) scale based on demographic and clinical factors present upon initial admission. It was noted that patient outcomes could be improved and health care costs reduced if strategies tailored to each patient could be implemented by risk-stratifying these patients using models such as the RAHF scale.

Methods

• Using the State Inpatient Database (2006-2011), discharge data including demographic and clinical characteristics on 642,448 patients with CHF from California and New York (derivation cohort) and 365,359 patients with CHF from Florida and Washington (validation cohort) were extracted.
• The Readmission After Heart Failure (RAHF) scale was created to foresee readmission risk.

Results

• It was determined that the 30-day readmission rates were 9.42 and 9.17% in the derivation and validation cohorts, respectively.
• Findings demonstrated that age <65 years, male gender, first income quartile, African American race, race other than African American or Caucasian, Medicare, Medicaid, self-pay/no insurance, drug abuse, renal failure, chronic pulmonary disorder, diabetes, depression, and fluid and electrolyte disorder were related to higher readmission risk after hospitalization for CHF.
• The RAHF defined the 95% of readmission variability within the validation cohort.
• The RAHF scale aided in defining the following 3 levels of risk for readmission: Low (RAHF score <12; 7.58% readmission rate), moderate (RAHF score 12-15; 9.78% readmission rate), and high (RAHF score >15; 12.04% readmission rate).
• Relative risk of readmission was 1.67 for the high-risk group vs the low-risk group.