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Short-term PM2.5 exposure and early-readmission risk: A retrospective cohort study in North Carolina Heart Failure Patients

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Background Short-term changes in ambient fine particulate matter (diameter ≤ 2.5 μm, PM2.5) air pollution increase the risk for cardiovascular hospital admission and readmission. Objectives Associations described in prior studies were reported using low-resolution PM2.5 data from city monitors and large administrative regions. Here we improve on these methods and utilize fine-resolution air pollution data to examine the PM2.5-related 30-day readmission risk in heart failure (HF) patients and examine how this risk varies with respect to time following discharge. Methods We performed a retrospective cohort study of 17,674 patients with a recorded HF diagnosis between 2004 and 2016. The cohort was identified using the EPA CARES electronic health record resource. The association between daily PM2.5 and 30-day readmissions were evaluated using time-dependent Cox proportional hazard models. Fine-resolution ambient PM2.5 data were assigned to patient residential address and hazard ratios are expressed per 1 μg/m3 of PM2.5. Results The hazard of a PM2.5-related readmission within three days of discharge was 1.029 (95% CI 1.017-1.042). This PM2.5 readmission hazard was significantly elevated in non-urban areas (1.036, 95%CI 1.020-1.052) and for events not preceded by a prescription for a beta-blocker (1.030; 95% CI 1.018-1.043). Conclusions Our findings add to the evidence indicating increased air quality-related health risks in individuals with underlying cardiovascular disease. Hospital readmissions are key metrics for patients and providers alike. As a potentially modifiable risk factor, air pollution-related interventions may be enacted that might assist in reducing costly and burdensome unplanned readmissions.

Impact/Purpose

This manuscript describes associations between daily PM2.5 exposure and 30-day readmissions among heart failure patients

Citation

Wyatt, L., A. Weaver, J. Moyer, J. Schwartz, Q. Di, D. Diazsanchez, W. Cascio, AND C. Ward-Caviness. Short-term PM2.5 exposure and early-readmission risk: A retrospective cohort study in North Carolina Heart Failure Patients. Mosby Year Book Incorporated, Orlando, FL, 248:130-138, (2022). [DOI: 10.1016/j.ahj.2022.02.015]

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DOI: Short-term PM2.5 exposure and early-readmission risk: A retrospective cohort study in North Carolina Heart Failure Patients
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Last updated on November 12, 2024
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