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Contribution of the long-term care insurance certificate for predicting 1-year all-cause readmission compared with validated risk scores in elderly patients with heart failure
- Source :
- Open Heart
- Publication Year :
- 2016
- Publisher :
- BMJ Publishing Group, 2016.
-
Abstract
- Objectives Readmission is a common and serious problem associated with heart failure (HF). Unfortunately, conventional risk models have limited predictive value for predicting readmission. The recipients of long-term care insurance (LTCI) are frail and have mental and physical impairments. We hypothesised that adjustment of the conventional risk score with an LTCI certificate enables a more accurate appreciation of readmission for HF. Methods We investigated 452 patients with HF who were followed up for 1 year to determine all-cause readmission. We obtained their clinical and socioeconomic data, including LTCI. The three clinical risk scores used in our evaluation were Keenan (2008), Krumholz (2000) and Charlson (1994). We used net reclassification improvement (NRI) to assess the incremental benefit. Results Patients with LTCI were significantly older, and had a higher prevalence of cerebrovascular disease and dementia than those without LTCI. One-year all-cause readmission (n=193, 43%) was significantly associated with all risk scores, receiving LTCI and the category of LTCI. Receiving LTCI was associated with readmission independent of all risk scores (HR, 1.59 to 1.63; all p
- Subjects :
- medicine.medical_specialty
Framingham Risk Score
Ejection fraction
business.industry
medicine.disease
Cardiac Risk Factors and Prevention
Net reclassification improvement
HEART FAILURE
Heart failure
Emergency medicine
Medicine
Dementia
In patient
Risk score
Long-term care insurance
Cardiology and Cardiovascular Medicine
business
Intensive care medicine
All cause mortality
Readmission
Subjects
Details
- Language :
- English
- ISSN :
- 20533624
- Volume :
- 3
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Open Heart
- Accession number :
- edsair.doi.dedup.....d3d2f376c15e53b4571bd4f5bfa28e3e