Key result
Unplanned 30-day hospital readmission occurred in 26.4% of heart failure patients, with rural residency (AHR 2.47), age >65, comorbidities, low hemoglobin, and high mean platelet volume identified as independent predictors.
Why the study?
Heart failure is a leading cause of unplanned readmissions with a heightened impact in resource-limited settings like Ethiopia, making the identification of contributing factors crucial.
Cohort (n=572)
Yes
Hazard Ratio: 2.47 (95% CI 1.44–4.24)
p-value: p=<0.05
Unplanned 30-day hospital readmission is high (26.4%) among heart failure patients in Ethiopia, with older age, rural residency, comorbidities (COPD/Asthma, HIV/AIDS), low hemoglobin, and high mean platelet volume identified as key predictors.
May guide risk stratification in Ethiopian HF care; observational data leaves open prospective validation of interventions.
Background The burden of heart failure increases over time and is a leading cause of unplanned readmissions worldwide. In addition, its impact has doubled in countries with limited health resources, including Ethiopia. Identifying and preventing the possible contributing factors is crucial to reduce unplanned hospital readmission and to improve clinical outcomes. Method A hospital-based retrospective cohort study design was employed from January 1, 2016, to December 30, 2020. The data was collected from 572 randomly selected medical records using data extraction checklists. Data were entered in Epi-data version 4.6 and analyzed with Stata version 17. The Kaplan-Meier and log-rank tests were used to estimate and compare the survival failure time. A Cox proportional hazard analysis was computed to identify predictors of readmission. Finally, the statistical significance level was declared at a p-value <0.05 with an adjusted odds ratio and a 95% confidence interval. Result In this study, a total of 151 (26.40%) heart failure patients were readmitted within 30 days of discharge. In the multivariate cox proportional hazards analysis being an age (>65 years) (AHR: 3.172, 95%CI:.21, 4.55), rural in residency (AHR: 2.47, 95%CI: 1.44, 4.24), Asthma/COPD (AHR: 1.62, 95%CI: 1.11, 2.35), HIV/AIDS (AHR: 1.84, 95%CI: 1.24, 2.75), Haemoglobin level 8-10.9 g/dL (AHR: 6.20, 95%CI: 3.74, 10.28), and Mean platelet volume >9.1fl (AHR: 2.08, 95%CI: 1.27, 3.40) were identified as independent predictors of unplanned hospital readmission. Conclusion The incidence of unplanned hospital readmission was relatively high among heart failure patients. Elderly patients, rural residency, comorbidity, higher mean platelet volume, and low hemoglobin level were independent predictors of readmission. Therefore, working on these factors will help to reduce the hazard of unplanned hospital readmission.
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Ayenew et al. (2022) conducted a cohort in Heart failure (n=572). Rural residency vs. Urban residency was evaluated on Unplanned hospital readmission within 30 days of discharge (AHR 2.47, 95% CI 1.44-4.24, p=<0.05). Unplanned 30-day hospital readmission occurred in 26.4% of heart failure patients, with rural residency (AHR 2.47), age >65, comorbidities, low hemoglobin, and high mean platelet volume identified as independent predictors.
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