Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients

Detalhes bibliográficos
Autor(a) principal: Sarteschi,Camila
Data de Publicação: 2020
Outros Autores: Souza,Wayner Vieira de, Medeiros,Carolina, Oliveira,Paulo Sergio Rodrigues, Martins,Silvia Marinho, Cesse,Eduarda Ângela Pessoa
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Journal of Cardiovascular Sciences (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000200175
Resumo: Abstract Background Heart failure (HF) is worldwide known as a public health issue with high morbimortality. One of the issues related to the evolution of HF is the high rate of hospital readmission caused by decompensation of the clinical condition, with high costs and worsening of ventricular function. Objective To quantify the readmission rate and identify the predictors of rehospitalization in patients with acute decompensated heart failure. Methods Hospital-based historic cohort of patients admitted with acute decompensated HF in a private hospital from Recife/PE, from January 2008 to February 2016, followed-up for at least 30 days after discharge. Demographic and clinical data of admission, hospitalization, and clinical and late outcomes were analyzed. Logistic regression was used as a strategy to identify the predictors of independent risks. Results 312 followed-up patients, average age 73 (± 14), 61% males, 51% NYHA Class III, and 58% ischemic etiology. Thirty-day readmission rate was 23%. Multivariate analysis identified the independent predictors ejection fraction < 40% (OR = 2.1; p = 0.009), hyponatremia (OR = 2.9; p = 0.022) and acute coronary syndrome (ACS) as the cause of decompensation (OR = 1.1; p = 0,026). The final model using those three variables presented reasonable discriminatory power (C-Statistics = 0.655 – HF 95%: 0.582 – 0.728) and good calibration (Hosmer-Lemeshow p = 0.925). Conclusions Among hospitalized patients with acute decompensated heart failure, the rate of readmission was high. Hyponatremia, reduced ejection fraction and ACS as causes of decompensation were robust markers for the prediction of hospital readmission within 30 days of discharge. (Int J Cardiovasc Sci. 2020; 33(2):175-184)
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spelling Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure PatientsHeart FailureHospitalizationPatient ReadmissionPatient Discharge/trendsAbstract Background Heart failure (HF) is worldwide known as a public health issue with high morbimortality. One of the issues related to the evolution of HF is the high rate of hospital readmission caused by decompensation of the clinical condition, with high costs and worsening of ventricular function. Objective To quantify the readmission rate and identify the predictors of rehospitalization in patients with acute decompensated heart failure. Methods Hospital-based historic cohort of patients admitted with acute decompensated HF in a private hospital from Recife/PE, from January 2008 to February 2016, followed-up for at least 30 days after discharge. Demographic and clinical data of admission, hospitalization, and clinical and late outcomes were analyzed. Logistic regression was used as a strategy to identify the predictors of independent risks. Results 312 followed-up patients, average age 73 (± 14), 61% males, 51% NYHA Class III, and 58% ischemic etiology. Thirty-day readmission rate was 23%. Multivariate analysis identified the independent predictors ejection fraction < 40% (OR = 2.1; p = 0.009), hyponatremia (OR = 2.9; p = 0.022) and acute coronary syndrome (ACS) as the cause of decompensation (OR = 1.1; p = 0,026). The final model using those three variables presented reasonable discriminatory power (C-Statistics = 0.655 – HF 95%: 0.582 – 0.728) and good calibration (Hosmer-Lemeshow p = 0.925). Conclusions Among hospitalized patients with acute decompensated heart failure, the rate of readmission was high. Hyponatremia, reduced ejection fraction and ACS as causes of decompensation were robust markers for the prediction of hospital readmission within 30 days of discharge. (Int J Cardiovasc Sci. 2020; 33(2):175-184)Sociedade Brasileira de Cardiologia2020-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000200175International Journal of Cardiovascular Sciences v.33 n.2 2020reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.36660/ijcs.20180088info:eu-repo/semantics/openAccessSarteschi,CamilaSouza,Wayner Vieira deMedeiros,CarolinaOliveira,Paulo Sergio RodriguesMartins,Silvia MarinhoCesse,Eduarda Ângela Pessoaeng2022-09-09T00:00:00Zoai:scielo:S2359-56472020000200175Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2022-09-09T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false
dc.title.none.fl_str_mv Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
title Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
spellingShingle Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
Sarteschi,Camila
Heart Failure
Hospitalization
Patient Readmission
Patient Discharge/trends
title_short Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
title_full Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
title_fullStr Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
title_full_unstemmed Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
title_sort Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
author Sarteschi,Camila
author_facet Sarteschi,Camila
Souza,Wayner Vieira de
Medeiros,Carolina
Oliveira,Paulo Sergio Rodrigues
Martins,Silvia Marinho
Cesse,Eduarda Ângela Pessoa
author_role author
author2 Souza,Wayner Vieira de
Medeiros,Carolina
Oliveira,Paulo Sergio Rodrigues
Martins,Silvia Marinho
Cesse,Eduarda Ângela Pessoa
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Sarteschi,Camila
Souza,Wayner Vieira de
Medeiros,Carolina
Oliveira,Paulo Sergio Rodrigues
Martins,Silvia Marinho
Cesse,Eduarda Ângela Pessoa
dc.subject.por.fl_str_mv Heart Failure
Hospitalization
Patient Readmission
Patient Discharge/trends
topic Heart Failure
Hospitalization
Patient Readmission
Patient Discharge/trends
description Abstract Background Heart failure (HF) is worldwide known as a public health issue with high morbimortality. One of the issues related to the evolution of HF is the high rate of hospital readmission caused by decompensation of the clinical condition, with high costs and worsening of ventricular function. Objective To quantify the readmission rate and identify the predictors of rehospitalization in patients with acute decompensated heart failure. Methods Hospital-based historic cohort of patients admitted with acute decompensated HF in a private hospital from Recife/PE, from January 2008 to February 2016, followed-up for at least 30 days after discharge. Demographic and clinical data of admission, hospitalization, and clinical and late outcomes were analyzed. Logistic regression was used as a strategy to identify the predictors of independent risks. Results 312 followed-up patients, average age 73 (± 14), 61% males, 51% NYHA Class III, and 58% ischemic etiology. Thirty-day readmission rate was 23%. Multivariate analysis identified the independent predictors ejection fraction < 40% (OR = 2.1; p = 0.009), hyponatremia (OR = 2.9; p = 0.022) and acute coronary syndrome (ACS) as the cause of decompensation (OR = 1.1; p = 0,026). The final model using those three variables presented reasonable discriminatory power (C-Statistics = 0.655 – HF 95%: 0.582 – 0.728) and good calibration (Hosmer-Lemeshow p = 0.925). Conclusions Among hospitalized patients with acute decompensated heart failure, the rate of readmission was high. Hyponatremia, reduced ejection fraction and ACS as causes of decompensation were robust markers for the prediction of hospital readmission within 30 days of discharge. (Int J Cardiovasc Sci. 2020; 33(2):175-184)
publishDate 2020
dc.date.none.fl_str_mv 2020-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472020000200175
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.36660/ijcs.20180088
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia
publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia
dc.source.none.fl_str_mv International Journal of Cardiovascular Sciences v.33 n.2 2020
reponame:International Journal of Cardiovascular Sciences (Online)
instname:Sociedade Brasileira de Cardiologia (SBC)
instacron:SBC
instname_str Sociedade Brasileira de Cardiologia (SBC)
instacron_str SBC
institution SBC
reponame_str International Journal of Cardiovascular Sciences (Online)
collection International Journal of Cardiovascular Sciences (Online)
repository.name.fl_str_mv International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)
repository.mail.fl_str_mv tailanerodrigues@cardiol.br||revistaijcs@cardiol.br
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