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Submitted: 06 Feb 2021
Revision: 07 Feb 2022
Accepted: 14 Feb 2022
ePublished: 12 Mar 2022
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J Cardiovasc Thorac Res. 2022;14(1): 11-17.
doi: 10.34172/jcvtr.2022.08
PMID: 35620751
PMCID: PMC9106947
Scopus ID: 85132131775
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Original Article

Predictors of readmission in hospitalized heart failure patients

Nasim Naderi 1 ORCID logo, Maryam Chenaghlou 2* ORCID logo, Marzieh Mirtajaddini 1, Zeinab Norouzi 1, Nasibeh Mohammadi 1,3, Ahmad Amin 1, Sepideh Taghavi 1, Hamidreza Pasha 1, Reza Golpira 1

1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran ,Iran
2 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3 Zanjan University of Medical Sciences, Zanjan, Iran
*Corresponding Author: *Corresponding Author: Maryam Chenaghlou, Email: , Email: mchenaghlou@yahoo.com

Abstract

Introduction: Heart failure(HF) related hospitalization constitutes a significant proportion of healthcare cost. Unchanging rates of readmission during recent years, shows the importance of addressing this problem.
Methods: Patients admitted with heart failure diagnosis in our institution during April 2018to August 2018 were selected. Clinical, para-clinical and imaging data were recorded. All included patients were followed up for 6 months. The primary endpoints of the study were prevalence of early readmission and the predictors of that. Secondary end points were in-hospital and 6-month post-discharge mortality rate and late readmission rate.
Results: After excluding 94 patients due to missing data, 428 patients were selected. Mean age of patients was 58.5 years (±17.4) and 61% of patients were male. During follow-up, 99patients (24%) were readmitted. Early re-admission (30-day) occurred in 27 of the patients(6.6%). The predictors of readmission were older age ( P=0.006), lower LVEF (P <0.0001), higher body weight (P=0.01), ICD/CRT implantation ( P=0.001), Lower sodium ( P=0.01), higher Pro-BNP(P=0.01), Higher WBC count (P=0.01) and higher BUN level (P=0.02). Independent predictors of early readmission were history of device implantation (P=0.007), lower LVEF (P=0.016), QRS duration more than 120 ms (P=0.037), higher levels of BUN (P=0.008), higher levels of Pro-BNP(P=0.037) and higher levels of uric acid (P=0.035). Secondary end points including in-hospital and 6-month post-discharge mortality occurred in 11% and 14.4% of patients respectively.
Conclusion: Lower age of our heart failure patients and high prevalence of ischemic cardiomyopathy, necessitate focusing on more preventable factors related to heart failure.


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