Rehospitalization for congestive heart failure (CHF) is high within 6 months of discharge.
Sleep disordered breathing (SDB) is common and underdiagnosed condition in patients
with CHF. We hypothesized that early recognition and treatment of SDB in hospitalized
patients with CHF will reduce hospital readmissions and emergency room visits. Patients
admitted for CHF underwent overnight polysomnography within 4 weeks of discharge.
Patients diagnosed with SDB were provided therapy with positive airway pressure therapy.
Patients were identified as having good compliance if the device use was for a minimum
of 4 hours 70% of the time for a minimum of 4 weeks during the first 3 months of therapy.
Hospital admissions for 6 months before therapy were compared with readmission within
6 months after therapy in patients with good and poor compliance. A total of 70 patients
were diagnosed with SDB after discharge. Of the 70 patients, 37 (53%) were compliant
with positive airway pressure therapy. Compliant patients were more likely to be older
(64 ± 12 vs 58 ± 11 years) and women (54% vs 33%) and less likely to be patient with
diabetes (40% vs 67%) versus noncompliant patients. Although both groups experienced
a decrease in total readmissions, compliant patients had a significant reduction (mean
± SE: −1.5 ± 0.2 clinical events vs −0.2 ± 0.3; p <0.0001). In this single-center
analysis, identification and treatment of SDB in admitted patients with CHF with SDB
is associated with reduced readmissions over 6 months after discharge. Adherence to
the treatment was associated with a greater reduction in clinical events.
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Article Info
Publication History
Published online: December 31, 2015
Accepted:
December 18,
2015
Received in revised form:
December 18,
2015
Received:
October 8,
2015
Footnotes
See page 944 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.