SHM Converge Scientific Abstract ePoster Gallery-Heart Failure Doubletake: Exploring Prevalence, Mortality, Readmissions, and Data Reliability at an Academic Medication Center

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This project reviewed 692 August 2024 discharges from a Department of Medicine service at Thomas Jefferson University Hospital to better characterize heart failure admissions and assess how manual chart review compares with automated/Vizient data.<br /><br />Using intravenous diuretic administration plus manual diagnosis confirmation, 73 patients (10.5%) were identified as heart failure admissions. Among these, 52% had HFrEF, 34% HFpEF, 10% HFmrEF, and 3% HFimpEF. Most heart failure patients were cared for on cardiology services (66%), while 34% were managed by hospital medicine. This differed from Vizient data, which suggested a 4:1 cardiology-to-hospital-medicine ratio.<br /><br />Inpatient mortality among manually reviewed heart failure admissions was 5.5%, compared with 3.3% in the Vizient comparator cohort. However, observed-to-expected mortality was 0.96 in the manual review versus 1.53 in Vizient data, suggesting differences in denominator accuracy and/or documentation quality. Thirty-day index-hospital readmission was 15% by manual review, similar to the Vizient value of 14.8%.<br /><br />The authors note that their method likely missed some heart failure admissions because it was limited to patients receiving IV diuretics and discharged from DOM. Even so, the manual review identified more heart failure admissions than Vizient data (73 vs 59–61), raising concerns about documentation, coding, and database reliability. The case mix was notable for a predominance of HFrEF/HFimpEF over HFpEF/HFmrEF, which reverses the usual community pattern and may indicate a higher-risk population that could benefit from targeted interventions.<br /><br />Overall, the study establishes baseline prevalence and outcomes, highlights discrepancies between manual and automated data sources, and supports using manual validation to improve future quality improvement measurement and intervention assessment.

Asset Subtitle

Alan A. Kubey

Meta Tag

Author List Alan A. Kubey, Avish Patel, Benjamin Richter, Comfort Elumogo, Joshua Riley, Katherine Freedberg, Marina Gonzalez, Meiqi Luo, Ryan Gardner, Sheraz Qamar, Virginia Gonzalez

Category Research

Concept Heart Failure Admission

Concept Chart Review

Concept Heart Failure Subtype

Concept General Medicine Discharge

Concept IV Diuretics

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital & Mayo Clinic

Presenting Author Alan A. Kubey

Track Quality Improvement

Keywords

heart failure

manual chart review

automated data

Vizient

hospital medicine

cardiology

inpatient mortality

readmission

HFrEF

quality improvement

Heart Failure Admission

Chart Review

Heart Failure Subtype

General Medicine Discharge

IV Diuretics