Do Hemoglobin and Creatinine Clearance Affect Hospital Readmission Rates from a Skilled Nursing Facility Heart Failure Rehabilitation Unit?

Objectives

Cardio renal anemia syndrome is being increasingly recognized in patients with congestive heart failure (CHF) and is associated with increased mortality and rehospitalization rates. Our objective was to assess the relationship between hemoglobin (Hb), creatinine clearance (C_Cr), and hospital readmission in elderly patients enrolled in a skilled nursing facility (SNF)-based CHF rehabilitation unit.

Methods

We retrospectively identified 127 consecutive patients admitted to an SNF-based CHF rehabilitation unit between July 2001 and September 2002. The patients were grouped into quintiles of hemoglobin and creatinine clearance (C_Cr) The rate of hospital readmission between quintiles of above variables was compared using the chi-square test.

Results

We found a higher prevalence of anemia than reported earlier in the literature for CHF patients discharged from hospital. Rehospitalization rates were increased two- and fivefold in lower compared to higher quintiles of hemoglobin and creatinine clearance, respectively. Anemia predicted rehospitalization in patients with renal dysfunction.

Conclusion

Our study suggests an association between anemia and rehospitalization rates in patients with renal dysfunction enrolled in an SNF-based CHF rehabilitation unit.

Keywords: Heart failure, cardio renal anemia, skilled nursing facility, hemoglobin, creatinine clearance, rehospitalization