Key result
Worsening dyspnea after heart failure discharge linked to ~5-fold higher odds of early readmission.
Why the study?
Characteristics and factors related to early readmission within 1 month after acute decompensated heart failure hospitalization were not well described.
Case-Control (n=198)
Yes
Odds Ratio: 4.96 (95% CI 1.16–21.2)
p-value: p=0.0306
Should not yet alter post-discharge monitoring; leaves open whether intervening on early dyspnea reduces readmissions in heart failure.
AIMS: To describe the main characteristics of patients who were readmitted to hospital within 1 month after an index episode for acute decompensated heart failure (ADHF).METHODS AND RESULTS: This is a nested case-control study in the ReIC cohort, cases being consecutive patients readmitted after hospitalization for an episode of ADHF and matched controls selected from those who were not readmitted. We collected clinical data and also patient-reported outcome measures, including dyspnea, Minnesota Living with Heart Failure Questionnaire (MLHFQ), Tilburg Frailty Indicator (TFI) and Hospital Anxiety and Depression Scale scores, as well as symptoms during a transition period of 1 month after discharge. We created a multivariable conditional logistic regression model.Despite cases consulted more than controls, there were no statistically significant differences in changes in treatment during this first month. Patients with chronic decompensated heart failure were 2.25 [1.25, 4.05] more likely to be readmitted than de novo patients. Previous diagnosis of arrhythmia and time since diagnosis ≥3 years, worsening in dyspnea, and changes in MLWHF and TFI scores were significant in the final model.CONCLUSION: We present a model with explanatory variables for readmission in the short term for ADHF. Our study shows that in addition to variables classically related to readmission, there are others related to the presence of residual congestion, quality of life and frailty that are determining factors for readmission for heart failure in the first month after discharge.ClinicalTrials.gov Identifier: NCT03300791. First registration: 03/10/2017
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García‐Gutiérrez et al. (2022) conducted a case-control in Acute decompensated heart failure (ADHF) (n=198). Worsening dyspnea vs. No change or improvement in dyspnea was evaluated on Early hospital readmission (within 1 month) (OR 4.96, 95% CI 1.16-21.20, p=0.0306). Worsening dyspnea during the first month after discharge for acute heart failure was associated with a nearly five-fold increased odds of early hospital readmission (OR 4.96).
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