Abstract 261: Insights into Hospital Readmission Patterns of Atrial Fibrillation Patients

Background: Atrial fibrillation (AF) is associated with morbidity, mortality, and rising costs. There is a paucity of data to inform best practices for care transition following AF hospitalization. We sought to characterize unplanned readmissions of AF patients. Methods: Retrospective data of patients discharged after AF hospitalization and referred to the NP-led transitional care program, BRIDGE, were abstracted from 2008-2012. Unplanned readmissions were dichotomized as early (<30 days) or late (31-180 days) readmits and classified as either AF-related; CV/non-AF; or non-AF/non-CV. Cases were adjudicated by a senior cardiologist. Demographics and readmission variables were compared. Results: Of 255 patients, 97 (38.0%) had unplanned readmissions within 180 days of discharge; 45 (46.4%) were early and 52 (53.6%) were late. AF and CV causes only accounted for 48.9% (n=31) of early readmissions and 65.4% (n=34) of late. Late readmits were more likely to have diabetes (32.7% v 17.7%, p=.022) and higher CHADS2VASc scores (3.63 v 2.98, p=.026) than those not readmitted. No other differences in baseline characteristics were seen between groups. The 30-day AF readmission rate in this sample was 17.6% (n=45). Conclusions: Readmissions following hospital discharge for AF are common and often for reasons that are neither AF nor CV-related. In order to reduce AF-related readmissions further research is needed to characterize readmission predictors and effective transitional care interventions.