Analysis of Factors Associated With Readmissions in Heart Failure Patients From Economically Underdeveloped Areas

Background Despite recent advancements in heart failure treatment, mortality and readmission rates remain high, continuing to place a substantial burden on society and families, especially in economically underdeveloped regions. Objective To analyze the factors contributing to readmissions among heart failure patients in these regions. Methods We retrospectively collected data from 309 patients with a confirmed diagnosis of heart failure who were hospitalized in our cardiology department between September 2023 and June 2024. The patients were divided into two groups: the readmission group (79 cases) and the non‐readmission group (230 cases). General demographic information, cardiovascular disease–related risk factors, comorbidities, echocardiographic findings, and cardiac function grades were obtained from our hospital’s electronic medical record system. Moreover, information regarding medication adherence and follow‐up visits was gathered through phone interviews and outpatient follow‐ups. Results In the readmission group, the proportion of male patients was lower (53.2% vs. 67.8%, p = 0.014), the proportion of patients with renal dysfunction was higher (39.2% vs. 25.7%, p = 0.022), the left ventricular ejection fraction (LVEF) was lower (39.53% vs. 45.75%, p < 0.001), the left ventricular end‐systolic diameter (LVESD) was larger (45.05 vs. 38.40 mm, p < 0.001), the left ventricular end‐diastolic diameter (LVEDD) was larger (56.70 vs. 50.34 mm, p < 0.001), and the left atrial diameter (LAD) was larger (46.68 vs. 38.58 mm, p < 0.001). The proportion of patients with severe valvular disease was higher (27.8% vs. 8.3%, p < 0.001), the proportion with moderate‐to‐severe pulmonary hypertension was higher (45.6% vs. 15.7%, p < 0.001), the proportion of patients with heart failure with reduced ejection fraction (HFrEF) was higher (75.9% vs. 60.4%, p = 0.013), and the proportion of patients with NYHA Class IV heart failure was higher (55.7% vs. 36.5%, p = 0.003). Additionally, the use of β ‐blockers in the readmission group was lower (67.1% vs. 83.9%, p = 0.001), and the rate of outpatient follow‐up was also lower (40.5% vs. 58.3%, p = 0.006). In the logistic multivariate analysis, female sex was found to have a statistically significant impact on the incidence of readmission (OR = 2.466, 95% CI 1.233–4.928, p = 0.011). Renal dysfunction also showed a statistically significant impact (OR = 0.491, 95% CI 0.254–0.953, p = 0.053), as did left atrial enlargement (OR = 0.945, 95% CI 0.912–0.979, p = 0.002). Low use of β ‐blockers was associated with a significant impact on readmission incidence (OR = 2.787, 95% CI 1.369–5.676, p = 0.005), as was a low rate of outpatient follow‐up (OR = 1.996, 95% CI 1.059–3.760, p = 0.032). Conclusions Women, coexisting renal dysfunction, left atrial enlargement, nonuse of β ‐blockers, and lack of outpatient follow‐up are independent risk factors for heart failure readmission. Therefore, greater attention should be given to women with heart failure, and efforts should focus on standardizing heart failure drug therapy, and outpatient follow‐up for heart failure patients should be strengthened.