In patients hospitalized with acute heart failure, the 30-day readmission rate was 6.6%, with independent predictors including history of device implantation (OR 23.82), lower LVEF, wide QRS, and higher BUN, Pro-BNP, and uric acid levels.
Cohort (n=428)
No
What are the clinical and laboratory predictors of early readmission and mortality in hospitalized patients with HFrEF?
In hospitalized patients with HFrEF, history of device implantation, lower LVEF, wide QRS, and elevated BUN, Pro-BNP, and uric acid are independent predictors of early readmission.
Odds Ratio: 23.82 (95% CI 2.33–242.59)
p-value: p=0.007
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.
Naderi et al. (Sat,) conducted a cohort in Acute heart failure with reduced ejection fraction (HFrEF) (n=428). Risk factors for early readmission (e.g., cardiac device implantation) vs. Patients without these risk factors was evaluated on Early (30-day) readmission (OR 23.82, 95% CI 2.33-242.59, p=0.007). In patients hospitalized with acute heart failure, the 30-day readmission rate was 6.6%, with independent predictors including history of device implantation (OR 23.82), lower LVEF, wide QRS, and higher BUN, Pro-BNP, and uric acid levels.