Clinical Scorecard: Risk of Unplanned 30-Day Readmission in Adults with Heart Failure or Acute Myocardial Infarction: A Comparison of Patients with and without HIV
At a Glance
Category
Detail
Condition
Heart failure (HF) and acute myocardial infarction (AMI)
Key Mechanisms
Higher incidence of HF and AMI in people with HIV (PWH) compared to people without HIV (PWoH); increased 30-day all-cause unplanned readmission risk among PWH
Target Population
Adults hospitalized for HF or AMI in the United States, stratified by HIV status
Care Setting
Community hospitals (nonfederal, short-term, general or specialty hospitals) across the United States
Key Highlights
From 2016 to 2022, 30-day readmission risk declined for both PWH and PWoH hospitalized for HF and AMI, but remained higher in PWH.
In 2022, PWH had a significantly higher adjusted risk ratio for 30-day readmission after HF (aRR=1.46) and AMI (aRR=1.59) compared to PWoH.
The most common readmission diagnoses were hypertensive heart disease with chronic kidney disease and HF for HF patients, and recurrent unspecified AMI for AMI patients.
Guideline-Based Recommendations
Diagnosis
Use ICD-10-CM codes to identify principal diagnoses of HF or AMI in hospitalized adults.
Consider HIV status as a factor influencing readmission risk.
Management
Implement targeted interventions such as early follow-up and multidisciplinary care for PWH to reduce 30-day readmission risk.
Focus on managing comorbid conditions like hypertension and chronic kidney disease in HF patients.
Monitoring & Follow-up
Track 30-day all-cause unplanned readmissions as a quality-of-care indicator.
Monitor readmission trends stratified by HIV status, age, and sex to identify high-risk subgroups.
Risks
PWH have a higher risk of 30-day readmission after HF and AMI hospitalizations compared to PWoH.
Younger males and older females with HIV show the largest disparities in readmission risk.
Patient & Prescribing Data
Adults hospitalized for HF or AMI with and without HIV infection in the United States
Antiretroviral therapy has reduced AIDS-related mortality but PWH remain at increased risk for cardiovascular events and readmissions; multidisciplinary care and early follow-up are recommended to mitigate readmission risk.
Clinical Best Practices
Incorporate HIV status assessment in cardiovascular hospitalization risk stratification.
Provide early post-discharge follow-up and multidisciplinary management for PWH hospitalized with HF or AMI.
Address comorbidities such as hypertension and chronic kidney disease to reduce readmission risk.
Use nationally representative data to monitor and improve quality of care related to readmissions.
