Higher heart failure symptom burden at hospital discharge significantly predicted 30-day clinical events (OR 5.7, P=0.003 for tertile 2; OR 4.3, P=0.021 for tertile 3).
Observational
Heart failure (n=186)
Heart failure symptom burden (Heart Failure Somatic Perception Scale) vs Lower symptom burden
30-day clinical events — OR 5.7 and OR 4.3, p=0.003 and 0.021
BACKGROUND: The relationship between heart failure (HF) symptoms at hospital discharge and 30-day clinical events is unknown. Variability in HF symptom assessment may affect ability to predict readmission risk. OBJECTIVE: The aim of this study was to describe HF symptom profiles and burden at hospital discharge. A secondary aim was to examine the relationship between symptom burden at discharge and 30-day clinical events. METHODS: An exploratory descriptive design was used. Patients with HF (n = 186) were enrolled 24 to 48 hours pre hospital discharge. The HF Somatic Perception Scale quantified 18 HF physical signs and symptoms. Scores were divided into tertiles (0-10, 11-19, and 20 and higher). The Patient Health Questionnaire-9 quantified depressive symptoms. Self-assessed health, comorbid illnesses, and 30-day clinical events were documented. Chi-square and logistic regression were used to examine clinical events. RESULTS: The sample (n = 186) was predominantly White (87.6%), male (59.1%), elderly (mean SD, 74.2 12.5), and symptomatic (92.5%) at discharge. Heart Failure Somatic Perception Scale scores ranged from 0 to 53, with a mean (SD) of 13.7 (10.1). Symptoms reported most frequently were fatigue (67%), nocturia (62%), need to rest (53%), and inability to do usual activities due to shortness of breath (52%). Thirty-day event rate was 28%, with significant differences between Heart Failure Somatic Perception Scale tertiles (9.4% vs 37.7% in the second and third tertiles, respectively; χ2(N = 186) = 16.73, P < .001). Heart Failure Somatic Perception Scale tertile 2 or 3 (odds ratio OR, 5.7; P = .003; and OR, 4.3; P = .021), self-assessed health (OR, 2.6; P = .029), and being in a relationship predicted clinical events. CONCLUSIONS: Heart failure symptom burden at discharge predicted 30-day clinical events. Comprehensive symptom assessment is important when determining readmission risk.
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Laura Senecal
Corrine Y. Jurgens
The Journal of Cardiovascular Nursing
Chestnut Hill College
St. Francis Hospital
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Senecal et al. (Tue,) conducted a observational in Heart failure (n=186). Heart failure symptom burden (Heart Failure Somatic Perception Scale) vs. Lower symptom burden was evaluated on 30-day clinical events (OR 5.7 and OR 4.3, p=0.003 and 0.021). Higher heart failure symptom burden at hospital discharge significantly predicted 30-day clinical events (OR 5.7, P=0.003 for tertile 2; OR 4.3, P=0.021 for tertile 3).
www.synapsesocial.com/papers/6a0859537de338f10b109fe1 — DOI: https://doi.org/10.1097/jcn.0000000000000767