Abstract
BackgroundHeart failure poses a significant burden on health care and economy. In recent years, diastolic dysfunction has been increasingly recognized as a significant predictor of readmission in heart failure patients.ObjectivesWe aimed to identify factors predicting readmission in patients with clinical heart failure at 30 days and six months.MethodsA retrospective chart review was performed at a single urban medical center, including 208 patients in our final analysis.ResultsA higher Charlson comorbidity index (CCI) and moderate anemia (hemoglobin [Hb] < 10 g/dL) were significant predictors of readmission at both 30 days and six months. In addition, advanced chronic kidney disease (CKD) stage (4 or 5) and follow-up in a cardiology clinic were significant predictors at six months. During multivariate analysis, worsening diastolic dysfunction (grade 3 or 4) (OR: 2.09; 95% CI: 1.03 to 4.23), higher CCI (OR: 1.18; 95% CI: 1.03-1.36), and Hb < 10 g/dL (OR: 3.42; 95% CI: 1.44-8.13) were independent predictors of readmission at 30 days. Higher CCI (OR: 1.37; 95% CI: 1.19-1.58) and CKD stage 4 or 5 (OR: 3.05; 95% CI: 1.40-6.62) were independent predictors of readmission at six months.ConclusionsWorse diastolic dysfunction (grade 3 or 4) was a significant predictor of all-cause readmission at 30 days post-discharge in heart failure patients. Higher CCI precisely predicted readmission as an independent variable at 30 days and six months. Anemia (Hb < 10 g/dL) and CKD stage 4 or 5 were significant predictors of readmission at 30-days and six months, respectively.
Highlights
Heart failure (HF) affects an estimated 6.5 million Americans ≥ 20 years of age and has an expected increase in prevalence by 46% from 2012 to 2030 [1]
During multivariate analysis, worsening diastolic dysfunction (OR: 2.09; 95% CI: 1.03 to 4.23), higher Charlson comorbidity index (CCI) (OR: 1.18; 95% CI: 1.03-1.36), and Hb < 10 g/dL (OR: 3.42; 95% CI: 1.44-8.13) were independent predictors of readmission at 30 days
Higher CCI (OR: 1.37; 95% CI: 1.19-1.58) and chronic kidney disease (CKD) stage 4 or 5 (OR: 3.05; 95% CI: 1.40-6.62) were independent predictors of readmission at six months
Summary
Heart failure (HF) affects an estimated 6.5 million Americans ≥ 20 years of age and has an expected increase in prevalence by 46% from 2012 to 2030 [1]. It is one of the leading causes of morbidity and mortality and poses a high economic burden on both the patient and the society due to high health-care-related costs projecting from $24.7 billion in 2010 to $77.7 billion in 2030 in the United States [2,3]. Diastolic dysfunction has been increasingly recognized as a significant predictor of readmission in heart failure patients
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