{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T21:19:28Z","timestamp":1771190368985,"version":"3.50.1"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jaoa.2020.154_s_001_w2aab3b7c10b1b6b1aab1c16b1Aa\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Cases of heart failure with preserved ejection fraction (HFpEF) exacerbations continue to affect patients' quality of life and cause significant financial burden on our healthcare system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2020.154_s_002_w2aab3b7c10b1b6b1aab1c16b2Aa\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify risk factors for readmission in patients discharged with a diagnosis of HFpEF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2020.154_s_003_w2aab3b7c10b1b6b1aab1c16b3Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Electronic health records of patients over 18 years of age with a primary diagnosis of HFpEF treated between August 1, 2017 and March 1, 2018 in a community hospital were retrospectively reviewed. The study population included patients with HFpEF greater than 40% who were screened but did not qualify for the ongoing CONNECT- HF trial being conducted by Duke Clinical Research. To be included, subjects had to fall into 1 of 2 classifications (NYHA Class II-IV or ACC\/AHA Stage B-D) and have a life expectancy greater than 6 months. Patients were excluded if they had terminal illness other than HF, a prior heart transplant or were on a transplant list, a current or planned placement of a left ventricular assist device, chronic kidney disease requiring hemodialysis, inability to use mobile applications, or inability to participate in longitudinal follow up. Readmission rate was analyzed at 30 and 90 days along with patients\u2019 demographics and associated comorbidities, including peripheral vascular disease, anemia, pulmonary hypertension, arrythmia, and valvular heart disease. Patients were risk stratified using the LACE index readmission score and the Charlson comorbidity index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2020.154_s_004_w2aab3b7c10b1b6b1aab1c16b4Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 492 cases of HFpEF identified during the 7-month study period, 212 patients were included. The majority of patients were women (126; 59.4%), had a median body mass index above 30 kg\/m<jats:sup>2<\/jats:sup> (123; 58%), and had pulmonary hypertension (94; 44.3%), anemia (146; 68.8%), and arrhythmia (101, 47.6%). Forty-five (21.2%) patients were readmitted for HFpEF within 90 days of initial discharge; 32 of those (71.1%) were readmitted within 30 days of initial discharge. Patients with higher LACE and Charlson comorbidity index scores were more likely to be readmitted within 90 days. Peripheral vascular disease (<jats:italic>P<\/jats:italic>=.002), tricuspid regurgitation (<jats:italic>P<\/jats:italic>=.001), pulmonary hypertension (<jats:italic>P<\/jats:italic>=.049), and anemia (<jats:italic>P<\/jats:italic>=.029) were risk factors associated with readmissions. Use of ACEi\/ARBs (<jats:italic>P<\/jats:italic>=.017) was associated with fewer readmissions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2020.154_s_005_w2aab3b7c10b1b6b1aab1c16b5Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Anemia, peripheral vascular disease, pulmonary hypertension, and valvular heart disease are not only postulated mechanisms of HFpEF, but also important risk factors for readmission. These study findings affirm the need for continued research of the pathophysiology and associated comorbidities of the HFpEF population to improve quality of life and lower healthcare costs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.7556\/jaoa.2020.154","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T15:00:49Z","timestamp":1604070049000},"page":"831-838","source":"Crossref","is-referenced-by-count":9,"title":["Readmission Risk Factors and Heart Failure With Preserved Ejection Fraction"],"prefix":"10.1515","volume":"120","author":[{"given":"Dustin","family":"Harmon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Rathousky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiza","family":"Choudhry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harjot","family":"Grover","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ishwar","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Jacobson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Boura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Arnautovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"issue":"16","key":"2021032622402378902_j_jaoa.2020.154_ref_001_w2aab3b7c10b1b6b1ab2ab1Aa","doi-asserted-by":"publisher","first-page":"e240","DOI":"10.1161\/CIR.0b013e31829e8776","article-title":"ACCF\/AHA guideline for the management of heart failure: a report of the american college of cardiology foundation\/american heart association task force on practice guidelines","volume":"128","year":"2013","journal-title":"Circulation"},{"issue":"6","key":"2021032622402378902_j_jaoa.2020.154_ref_002_w2aab3b7c10b1b6b1ab2ab2Aa","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1093\/eurheartj\/ehy301","article-title":"van Veldhuisen DJ","volume":"40","year":"2019 Feb 7","journal-title":"Heart failure with preserved ejection fraction: from mechanisms to therapies [published correction appears in Eur Heart J"},{"issue":"5","key":"2021032622402378902_j_jaoa.2020.154_ref_003_w2aab3b7c10b1b6b1ab2ab3Aa","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1007\/s12170-011-0184-2","article-title":"Heart failure with preserved ejection fraction: persistent diagnosis, therapeutic enigma","volume":"5","year":"2011","journal-title":"Curr Cardiovasc Risk Rep"},{"issue":"6","key":"2021032622402378902_j_jaoa.2020.154_ref_004_w2aab3b7c10b1b6b1ab2ab4Aa","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s11886-018-0978-7","article-title":"What is new in heart failure management in 2017? 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