Abstract 4147323: The Effects of Illicit Drug Use on Congestive Heart Failure Patients and Hospital Readmission Rates at Harlem Hospital Center

Introduction: CHF is defined as a chronic disease that impacts more than 5 million adults in the United States with significant population-wide impact on morbidity, mortality and hospitalization burden, especially amonth high-risk and vulnerable populations. Although the intricacies of CHF and readmission risk have been well documented, there have been fewer studies investigating the effect of illicit drug use on CHF patients and readmission outcomes especially in a population at high risk of health disparities. Objective: The purpose of this study was to examine the effects of illicit drug use on CHF patients and hospital readmission rates at Harlem Hospital Center with a high density of patients with health disparities. Methods: We included all patients admitted during a 2 year period (2019-2020) with a primary diagnosis of heart failure to Harlem Hospital Center and conducted in depth assessment of drug use history including patient history, available laboratory analysis, and collateral EMR information. Rehospitalization was assessed by review of EMR by trained medical professionals. Our results were analyzed using standard statistical methods between the two groups with and without history of drug use. Results: Our study population included 380 admitted CHF patients. The overall prevalence of illicit drug use in CHF patients was 32.89%, with the most common drug used being cocaine. CHF patients who used illicit drugs had a 22.58% 30-day readmission rate in comparison to 13.78% among CHF patients who didn’t use illicit drugs. In addition, CHF patients who used illicit drugs had higher all-time hospitalizations and were more likely to be admitted than non-illicit drug users in terms of heart failure hospitalizations. Overall, CHF patients who used any type of illicit drug were twice as likely to be readmitted after index hospitalization compared to CHF patients who didn’t use illicit drugs. We also found that CHF patients who used illicit drugs were slightly younger, more likely to be male, and more likely to smoke cigarettes. Lastly, we observed that at least 50% of CHF patients who used illicit drugs were on government assistance, lacked family support, and were unemployed. Conclusion: Drug use is a common problem among patients with CHF in this vulnerable population and is associated with significant adverse outcomes such as increased rehospitalization. Systemic efforts to address this at the patient and community level are justified.