Prediction of 30-Day Heart Failure-Specific Readmission Risk by Echocardiographic Parameters

It is unknown whether echocardiographic morphologic and hemodynamic parameters have incremental value in predicting 30-day heart failure (HF)-specific readmission risk among patients admitted with HF. We performed a prospective cohort study of adult patients entering a transitional care program after HF hospitalization to assess the role of echocardiographic parameters in predicting 30-day HF-specific readmission risk. Patients were followed for at least 30 days postdischarge, and readmission outcomes were ascertained prospectively. A previously validated 30-day HF readmission score (Yale Center for Outcome Research and Evaluation [CORE]) was calculated using 20 clinical and pathology parameters. Atrial and ventricular morphologic and hemodynamic variables were obtained from the index hospitalization echocardiogram. A Cox proportional hazards model was used to identify variables associated with 30-day HF specific readmission risk. Among 283 patients (mean age 72 ± 14 years, 57% men, 54% ischemic HF, ejection fraction 35% ± 17%) who underwent echocardiography during index admission there were 46 HF specific readmissions. After risk adjustment, elevated echocardiographic right atrial pressure (RAP; hazard ratio [HR] 3.70, 95% confidence interval [CI] 1.82 to 7.52, p