Rheumatoid arthritis and the risk of 90-day readmission after hospitalization for heart failure.

Objective: To determine the association of rheumatoid arthritis (RA) diagnosis on the risk of 90-day readmissions and in-hospital mortality during readmission episode within 90 days after index heart failure (HF) hospitalization.

Methods: We used the 2016-2019 U.S. Nationwide Readmissions Database (NRD) to examine the association between RA diagnosis and 90-day readmission and in-hospital mortality risk during the 90-day readmission after index HF hospitalization. We performed multivariable-adjusted logistic regression, adjusting for patient demographics, Deyo-Charlson comorbidity index, median household income for patient's ZIP code, primary expected payer, patient state residency status, teaching status of hospital, hospital control, and hospital bed size. We calculated adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI).

Results: Of the 3,718,425 with index HF hospitalizations during 2016-2019, 32.7 % (n = 1,214,185) were readmitted within 90-days of the index heart failure hospitalization. We found that RA diagnosis was significantly associated with both 90-day readmission and in-hospital mortality during readmission within 90 days after index HF hospitalization, with aOR 1.16 (95 % CI, 1.13-1.19), and aOR 1.12 (95 % CI, 1.04-1.20), respectively in multivariable-adjusted analysis. These findings were confirmed in additional sensitivity analysis.

Conclusions: We demonstrated a significant association of RA with both 90-day readmission and in-hospital mortality in HF rehospitalizations. Targeted interventions and other treatment options need to be explored to reduce the additional risk of readmission and mortality for patients with RA and HF.