Abstract
Background: No clinical studies have focused on the factors associated with discharge destination in patients with acute decompensated heart failure. Methods and Results: Of 4,056 consecutive patients hospitalized for ADHF in the KCHF registry, we analyzed 3,460 patients hospitalized from their homes and discharged alive. There were 3009 and 451 patients who were discharged to home (home discharge) and non-home (non-home discharge), respectively. We investigated the factors associated with non-home discharge and compared the outcomes between home discharge and non-home discharge. Factors independently and positively associated with non-home discharge were age ≥80 years (odds ratio [OR]:1.76, 95% confidence interval [CI]:1.28-2.42), body mass index ≤22 kg/m 2 (OR:1.49, 95%CI:1.12-1.97), poor medication adherence (OR:2.08,95%CI:1.49-2.88), worsening heart failure (OR:2.02, 95%CI:1.46-2.82), stroke during hospitalization (OR:3.74, 95%CI:1.75-8.00), functional decline (OR:12.24, 95%CI:8.74-17.14) and length of hospital stay >16 days (OR:4.14, 95%CI:3.01-5.69), while those negatively associated were diabetes mellitus (OR:0.69, 95%CI:0.51-0.94), cohabitants (OR:0.62, 95%CI:0.46-0.85), and ambulatory state before admission (OR:0.25, 95%CI:0.18-0.36). The cumulative 1-year incidence of all-cause death was significantly higher in the non-home discharge group than in the home discharge group. The non-home discharge group compared with the home discharge group was associated with a higher adjusted risk for all-cause death (HR:1.66, P <0.001). Conclusions: The discharge destination of acute decompensated heart failure patients is influenced by factors such as pre-hospital social background, age, body mass index, low self-care ability, events during hospitalization (worsening heart failure, stroke, etc.), functional decline, and length of hospital stay; moreover, the prognosis of non-home discharge patients is worse than that of home discharge patients.
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