Readmission rates following heart failure: a scoping review of sex and gender based considerations
Abstract Background Although hospital readmission for heart failure (HF) is an issue for both men and women, little is known about differences in readmission rates by sex. Consequently, strategies to optimize readmission reduction programs and care strategies for women and men remain unclear. Our st...
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doaj-c80abcef04664024845a44f86a5a00832020-11-25T03:12:01ZengBMCBMC Cardiovascular Disorders1471-22612020-05-0120111910.1186/s12872-020-01422-3Readmission rates following heart failure: a scoping review of sex and gender based considerationsAmy Hoang-Kim0Camilla Parpia1Cassandra Freitas2Peter C. Austin3Heather J. Ross4Harindra C. Wijeysundera5Karen Tu6Susanna Mak7Michael E. Farkouh8Louise Y. Sun9Michael J. Schull10Robin Mason11Douglas S. Lee12Paula A. Rochon13Women’s College Research InstituteWomen’s College Research InstitutePeter Munk Cardiac Centre of University Health NetworkICESPeter Munk Cardiac Centre of University Health NetworkICESFaculty of Medicine, University of TorontoFaculty of Medicine, University of TorontoPeter Munk Cardiac Centre of University Health NetworkICESICESWomen’s College Research InstitutePeter Munk Cardiac Centre of University Health NetworkWomen’s College Research InstituteAbstract Background Although hospital readmission for heart failure (HF) is an issue for both men and women, little is known about differences in readmission rates by sex. Consequently, strategies to optimize readmission reduction programs and care strategies for women and men remain unclear. Our study aims were: (1) to identify studies examining readmission rates according to sex, and (2) to provide a qualitative overview of possible considerations for the impact of sex or gender. Methods We conducted a scoping review using the Arksey and O’Malley framework to include full text articles published between 2002 and 2017 drawn from multiple databases (MEDLINE, EMBASE), grey literature (i.e. National Technical information, Duck Duck Go), and expert consultation. Eligible articles included an index heart failure episode, readmission rates, and sex/gender-based analysis. Results The search generated 5887 articles, of which 746 underwent full abstract text consideration for eligibility. Of 164 eligible articles, 34 studies addressed the primary outcome, 103 studies considered sex differences as a secondary outcome and 25 studies stratified data for sex. Good inter-rater agreement was reached: 83% title/abstract; 88% full text; kappa: 0.69 (95%CI: 0.53–0.85). Twelve of 34 studies reported higher heart failure readmission rates for men and six studies reported higher heart failure readmission rates for women. Using non composite endpoints, five studies reported higher HF readmission rates for men compared to three studies reporting higher HF readmission rates for women. Overall, there was heterogeneity between studies when examined by sex, but one observation emerged that was related to the timing of readmissions. Readmission rates for men were higher when follow-up duration was longer than 1 year. Women were more likely to experience higher readmission rates than men when time to event was less than 1 year. Conclusions Future studies should consider different time horizons in their designs and avoid the use of composite measures, such as readmission rates combined with mortality, which are highly skewed by sex. Co-interventions and targeted post-discharge approaches with attention to sex would be of benefit to the HF patient population.http://link.springer.com/article/10.1186/s12872-020-01422-3 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amy Hoang-Kim Camilla Parpia Cassandra Freitas Peter C. Austin Heather J. Ross Harindra C. Wijeysundera Karen Tu Susanna Mak Michael E. Farkouh Louise Y. Sun Michael J. Schull Robin Mason Douglas S. Lee Paula A. Rochon |
spellingShingle |
Amy Hoang-Kim Camilla Parpia Cassandra Freitas Peter C. Austin Heather J. Ross Harindra C. Wijeysundera Karen Tu Susanna Mak Michael E. Farkouh Louise Y. Sun Michael J. Schull Robin Mason Douglas S. Lee Paula A. Rochon Readmission rates following heart failure: a scoping review of sex and gender based considerations BMC Cardiovascular Disorders |
author_facet |
Amy Hoang-Kim Camilla Parpia Cassandra Freitas Peter C. Austin Heather J. Ross Harindra C. Wijeysundera Karen Tu Susanna Mak Michael E. Farkouh Louise Y. Sun Michael J. Schull Robin Mason Douglas S. Lee Paula A. Rochon |
author_sort |
Amy Hoang-Kim |
title |
Readmission rates following heart failure: a scoping review of sex and gender based considerations |
title_short |
Readmission rates following heart failure: a scoping review of sex and gender based considerations |
title_full |
Readmission rates following heart failure: a scoping review of sex and gender based considerations |
title_fullStr |
Readmission rates following heart failure: a scoping review of sex and gender based considerations |
title_full_unstemmed |
Readmission rates following heart failure: a scoping review of sex and gender based considerations |
title_sort |
readmission rates following heart failure: a scoping review of sex and gender based considerations |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2020-05-01 |
description |
Abstract Background Although hospital readmission for heart failure (HF) is an issue for both men and women, little is known about differences in readmission rates by sex. Consequently, strategies to optimize readmission reduction programs and care strategies for women and men remain unclear. Our study aims were: (1) to identify studies examining readmission rates according to sex, and (2) to provide a qualitative overview of possible considerations for the impact of sex or gender. Methods We conducted a scoping review using the Arksey and O’Malley framework to include full text articles published between 2002 and 2017 drawn from multiple databases (MEDLINE, EMBASE), grey literature (i.e. National Technical information, Duck Duck Go), and expert consultation. Eligible articles included an index heart failure episode, readmission rates, and sex/gender-based analysis. Results The search generated 5887 articles, of which 746 underwent full abstract text consideration for eligibility. Of 164 eligible articles, 34 studies addressed the primary outcome, 103 studies considered sex differences as a secondary outcome and 25 studies stratified data for sex. Good inter-rater agreement was reached: 83% title/abstract; 88% full text; kappa: 0.69 (95%CI: 0.53–0.85). Twelve of 34 studies reported higher heart failure readmission rates for men and six studies reported higher heart failure readmission rates for women. Using non composite endpoints, five studies reported higher HF readmission rates for men compared to three studies reporting higher HF readmission rates for women. Overall, there was heterogeneity between studies when examined by sex, but one observation emerged that was related to the timing of readmissions. Readmission rates for men were higher when follow-up duration was longer than 1 year. Women were more likely to experience higher readmission rates than men when time to event was less than 1 year. Conclusions Future studies should consider different time horizons in their designs and avoid the use of composite measures, such as readmission rates combined with mortality, which are highly skewed by sex. Co-interventions and targeted post-discharge approaches with attention to sex would be of benefit to the HF patient population. |
url |
http://link.springer.com/article/10.1186/s12872-020-01422-3 |
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