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September 1, 2026Cardiology ResearchOpen Access

Clinical and Metabolic Factors as Predictors of Thirty-Day Readmission in Patients With Acute Decompensated Heart Failure With Reduced Ejection Fraction and Type 2 Diabetes Mellitus

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Why the study?

Patients with HFrEF have high 30-day readmission rates, and about 30% of decompensated heart failure patients also have T2DM, motivating the determination of clinical and metabolic predictors of 30-day readmission in this population.

Population

747 clinical encounters of patients with ADHF with reduced ejection fraction and type-2 DM

Comparison

Readmission vs non-readmission groups

Design

Retrospective cohort study

Follow-up

30 days

Key result

Atrial fibrillation (OR 2.616) and higher discharge heart rate increased 30-day readmission risk, while postprandial glucose ≤140 mg/dL (OR 0.528) was protective in HFrEF and T2DM patients.

Authors

RSRarsari SoerarsoDHDian Yaniarti HasanahEYEmir Yonas

Discussion

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Member takes

Overview

AF and discharge heart rate may stratify readmission risk in HFrEF/T2DM; postprandial glucose association is hypothesis-generating.

Key Points

  • To identify the clinical and metabolic predictors of 30-day hospital readmission in patients with acute decompensated heart failure with reduced ejection fraction and type 2 diabetes mellitus.
  • Conducted a retrospective cohort study evaluating medical records from 747 clinical encounters at the National Cardiovascular Center Harapan Kita.
  • Identified independent predictors of 30-day readmission for worsening heart failure using multivariable logistic regression and bootstrapping validation.
  • Among 747 clinical encounters, 179 resulted in 30-day readmission (24% readmission rate).
  • Independent clinical predictors of 30-day readmission were atrial fibrillation (OR = 2.616; 95% CI, 1.604–4.267; P < 0.001) and elevated discharge heart rate (OR = 1.022; 95% CI, 1.005–1.039; P = 0.010).
  • Postprandial blood glucose ≤ 140 mg/dL served as a protective metabolic factor against 30-day readmission (OR = 0.528; 95% CI, 0.348–0.802; P = 0.003).

Study Design

Type

Cohort (n=747)

Multicenter

No

Structured PICO

P
Population
747 clinical encounters of patients with acute decompensated heart failure with reduced ejection fraction and type 2 diabetes mellitus, evaluated for 30-day readmission.
O
Outcome
Incidence of readmission due to worsening of the condition of heart failure at 30 days after the last admissionhard clinical

Main Result

Odds Ratio: 2.616 (95% CI 1.604–4.267)

p-value: p=<0.001

In patients with HFrEF and T2DM, atrial fibrillation and higher discharge heart rate predict 30-day readmission, whereas postprandial blood glucose ≤ 140 mg/dL is protective.

Limitations

  • Retrospective single-center design with limited external generalizability
  • Unmeasured socioeconomic factors
  • Inability to verify if patients achieved true maximum GDMT doses
  • Lack of longitudinal post-discharge tracking for medication compliance
  • Lack of uniform diagnostic workup for chronic kidney disease
  • Inclusion of multiple admissions from the same individual patient

Cite This Study

Soerarso et al. (2026) conducted a cohort in Acute Decompensated Heart Failure with Reduced Ejection Fraction and Type 2 Diabetes Mellitus (n=747). Atrial fibrillation vs. Sinus rhythm was evaluated on 30-day readmission due to worsening heart failure (OR 2.616, 95% CI 1.604-4.267, p=<0.001). Atrial fibrillation (OR 2.616) and higher discharge heart rate increased 30-day readmission risk, while postprandial glucose ≤140 mg/dL (OR 0.528) was protective in HFrEF and T2DM patients.

synapsesocial.com/papers/6a969b77535111e2d4ce8d0chttps://doi.org/10.14740/cr2206
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