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

ABSTRACT

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.