Predictors of Post-Discharge 30-Day Hospital Readmission in Decompensated Heart Failure Patients
Int. j. cardiovasc. sci. (Impr.)
; 33(2): 175-184, Mar.-Apr. 2020. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1090660
Biblioteca responsável:
BR1.1
ABSTRACT
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)
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 9: Redução de doenças não transmissíveis
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Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
Base de dados:
LILACS
Assunto principal:
Readmissão do Paciente
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Insuficiência Cardíaca
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Hospitalização
Tipo de estudo:
Estudo diagnóstico
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Estudo observacional
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Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso
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Idoso, 80 anos ou mais
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Feminino
/
Humanos
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Masculino
Idioma:
Inglês
Revista:
Int. j. cardiovasc. sci. (Impr.)
Assunto da revista:
Cardiologia
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
FIOCRUZ/BR
/
Pronto Socorro Cardiológico de Pernambuco Professor Luiz Tavares/BR
/
Real Hospital Português de Beneficência em Pernambuco/BR