SYSTOLIC FUNCTION, READMISSION RATES, AND SURVIVAL AMONG CONSECUTIVELY HOSPITALIZED-PATIENTS WITH CONGESTIVE-HEART-FAILURE

We sought to describe the relation between left ventricular systolic f unction and rates of hospital readmission and survival among consecuti vely hospitalized patients with congestive heart failure. Medical reco rds were reviewed for these patients at an academic medical center bet ween Jan. 1, 1992, and Dec. 31, 1993. Left ventricular systolic functi on assessments performed within 6 months before discharge were used to classify left ventricular systolic function. Hospital readmission rat es and survivor through Dec. 31, 1994, were compared between patients with systolic dysfunction and those with preserved systolic function. Among 412 patients hospitalized with a primary diagnosis of congestive heart failure, 224 had undergone a left ventricular function assessme nt during the 6 months before hospital discharge. In-hospital mortalit y and readmission rates were higher among patients without a recent as sessment of left ventricular systolic function. OF patients with systo lic dysfunction, 55% versus 41% of patients with preserved systolic fu nction were either readmitted or had an emergency room visit within 6 months after discharge (p = 0.06). At 27 months' follow-up, cumulative survival probabilities were 65% for patients with preserved systolic function, 65% for patients with systolic dysfunction, and 60% for pati ents without a left ventricular systolic function assessment (p = 0.24 ). Patients without a recent left ventricular systolic function assess ment have significantly higher hospital readmission rates than patient s with a recent systolic function assessment. Among hospitalized patie nts, mortality rates are comparable between patients with systolic dys function and those with preserved systolic function. However, patients with heart failure with systolic dysfunction may have higher readmiss ion rates.