Effect of early physician follow-up on mortality and subsequent hospital admissions after emergency care for heart failure: A retrospective cohort study

Abstract

BACKGROUND: The 1-year mortality rate relation to mortality and admissions to with patients without 30-day follow-up, in patients with heart failure who are dis-hospital for cardiovascular conditions. was associated with a reduction in 1-year charged from an emergency department mortality (HR 0.89, 95% CI 0.82–0.97) but is 20%. We sought to determine whether RESULTS: Of 34519 patients, 16274 (47.1%) not admission to hospital (HR 1.02, 95% CI early follow-up after discharge from the obtained follow-up care within 7 days and 0.94–1.10). In this group, there was a trend emergency department was associated 28846 (83.6%) within 30 days. Compared toward an increase in 90-day admission to with decreased mortality or subsequent with follow-up between day 8 and 30, hospital (HR 1.14, 95% CI 1.00–1.29). admission to hospital. patients with follow-up care within 7 days had a lower rate of mortality over 1 year INTERPRETATION: Follow-up care within METHODS: This retrospective cohort (hazard ratio [HR] 0.92; 95% confidence 7 days of discharge from the emergency study conducted in Ontario, Canada, interval [CI] 0.87–0.97), and a reduced rate department was associated with lower included adult patients who were dis-of admission to hospital over 90 days rates of long-term mortality, as well as sub-charged from 1 of 163 emergency depart-(HR 0.87, 95% CI 0.80–0.94) and 1 year sequent hospital admissions, and a trend ments between April 2007 and March 2014 (HR 0.92; 95% CI 0.87–0.97); the mortality to lower short-term mortality rates. Timely with a primary diagnosis of heart failure. rate over 90 days in this group trended to a access to longitudinal care for patients with Using a propensity score–matched land-lower rate (HR 0.90, 95% CI 0.10–1.00). heart failure who are discharged from the mark analysis, we assessed follow-up in Follow-up care within 30 days, compared emergency setting should be prioritized.