Characteristics and outcomes of patients with Heart Failure with Reduced Versus Preserved Ejection Fraction among patient enrolled in Community Health Program

Background: Readmission rates are high in the United States for both heart failure (HF) with preserved (HFpef) as well as reduced (HFref) ejection fraction. As the phenotype of patients and other co-morbid and socio-economic conditions may be different in both groups, we sought to compare the characteristics of patients in an urban, underserved population among with both types of HF. We also compared the effect of a novel community health worker (CHW) program on reducing 30-day readmissions among both groups. Method: All patients with heart failure who participated in the CHW program between September 2014 and November 2015 were included in the study. Patients who were homeless, resided at a long-term care facility, or were not followed at the outpatient practice were excluded. CHW visited eligible patients at home multiple times over the 30 days following hospital discharge. Patient baseline characteristics, number of previous admissions and ER visits, as well as 30-days readmission and ER visits were collected. Continuous variables were compared using t-test, while categorical variables were compared using Chi-square and Fisher exact test as appropriate. Result: A total of 87 patients were included in this study, of which 76% (n=66) were in HFref group. There were no differences in mean age, gender and race distribution between patients with HFref and HFpef. Patients with HFref were less likely to present with a history of chronic kidney disease (19.7% vs 55.0%, p\u3c.001) CHW program resulted in a significant reduction in the mean number of hospitalizations per patients at 30 days (mean (SD): 1.65(2.0) at baseline vs 0.18(0.5) at 30 days, p\u3c.001). Similar findings were observed in both HFref (mean (SD): 1.79 (2.1) vs 0.13 (0.4), p\u3c.001) as well as HFpef (mean (SD):1.17(1.4) vs 0.3(0.6), p=0.024) groups respectively. Conclusion: Patients with both HFref as well as HFpef were similar in their cor-morbidities and risk of readmission. Both groups benefited from CHW program with significant reductions in the 30 days readmission and improvement in quality life