AN ATTEMPT TO DECIPHER THE AMBIGUITIES OF INCREASED SIX MONTHS HOSPITAL READMISSION IN HEART FAILURE PATIENTS
Ashraf Shaat, MD, Amal Zakout, MD2, Khaled Alkhodari, MD and Mohammed Habib, MD, PHD
Background: Heart failure (HF) has high in-hospital mortality and is associated with high readmission rates. Reasons for and ways to avoid HF readmissions are unclear. Approximately one-third of patients admitted for HF are readmitted within 6 months. We still desperately need to know some of the independent variables that would define high-risk groups of HF patients for re-hospitalization. Methods and Results: This is a prospective, observational study enrolled patients with ejection fraction (EF) <40%, were admitted because of acute decompensation. Out of the total 164 patients 63% were male. The mean age of the study population was 65.79 ±14.118. Male vs female, living at home independently and self -pay were statistically significant in the readmitted group (P=0.042, 0.007, 0.001). Co morbidity and clinical finding which showed significance increase with readmission include; hypertension(P=0.013), Acute coronary syndrome (P=0.015), mitral regurgitation (P=0.002), aortic regurgitation (P=0.014), LBBB (P=0.048), Urosepsis (P=0.008), and EF (P=0.041). Parameters on logistic regression analysis anemia (OR,1.7; CI,0.8-3.4), hypertension (OR,2.5; CI,1.2-5.4), ejection fraction less than 30% (OR, 1.9; CI, 0.9-3.7), mitral regurgitation (OR, 2.8; CI, 1.4-5.6), hyponatremia (OR,2.0. CI, 0.5-7.6), and high creatinine (OR, 1.3; CI,0.6-2.8) were independently increased the risk of rehospitalization at six months of discharge. Conclusion: Rehospitalization rate was 33%. Higher rates of readmission were noted in those with older male, hypertensive patients, low EF, mitral regurgitation, impaired kidney function, anemia, hyponatremia, living at home independently and infections.
Keywords: Heart failure, Anemia, hospital readmission.
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