ADMISSION AND READMISSION IN HEART FAILURE, PREDICTORS OF READMISSION, AN EXPERIENCE AT AYUB TEACHING HOSPITAL ABBOTTABAD
DOI:
https://doi.org/10.55519/JAMC-02-12684Abstract
Background: Heart failure is a long-term health condition that is characterized by multiple re-admissions throughout the patient’s life. The economic burden and the impairment of quality of life are too prominent in patients with heart failure. The aim of the study was to determine re-admission rate and predictors of re-admission in patients with heart failure at Ayub Teaching hospital Abbottabad. Methods: A data of 350 patients with heart failure who were admitted & readmitted to the coronary care unit with heart failure were included in this study. Data was collected to determine the common factors that may dictate their readmission to hospital. Results: Over all re-admission rate was 58.28 %(n=204) for the patients in our study cohort. Regarding readmission rates within a 90-days period, 41.7% (n=146) of the sample had no readmission events, 35.1% (n=123) had one readmission, and 23.1% (n=81) experienced two or more readmissions. In terms of comorbid conditions, 36.9% (n=129) of the patients had a diagnosis of diabetes mellitus, while 57.7% (n=202) had hypertension. There was a statistically significant association between readmission within 90 days following first hospitalization for heart failure and diabetes mellitus, Increased Heart Rate, Nephropathy and an increased Neutrophil: Lymphocyte ratio (p<0.05). Conclusion: Diabetes mellitus, elevated heart rate, the presence of nephropathy, and an increased neutrophil-lymphocyte ratio were found to be independent predictors of subsequent heart failure readmission. These risk factors could potentially serve as simple indicators for forecasting the likelihood of heart failure readmission following patient discharge.References
Chun S, Tu JV, Wijeysundera HC, Austin PC, Wang X, Levy D, et al. Lifetime analysis of hospitalizations and survival of patients newly admitted with heart failure. Circ Heart Fail 2012;5(4):414–21.
Wong CX, Brooks AG, Leong DP, Roberts-Thomson KC, Sanders P. The increasing burden of atrial fibrillation compared with heart failure and myocardial infarction: a 15-year study of all hospitalizations in Australia. Arch Intern Med 2012;172(9):739–41.
Robertson J, McElduff P, Pearson SA, Henry DA, Inder KJ, Attia JR. The health services burden of heart failure: an analysis using linked population health data-sets. BMC Health Serv Res 2012;12(1):1–11.
Solomon SD, Dobson J, Pocock S, Skali H, McMurray JJ, Granger CB, et al. Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure. Circulation 2007;116(13):1482–7.
Setoguchi S, Stevenson LW, Schneeweiss S. Repeated hospitalizations predict mortality in the community population with heart failure. Am Heart J 2007;154(2):260–6.
Khan H, Greene SJ, Fonarow GC, Kalogeropoulos AP, Ambrosy AP, Maggioni AP, et al. Length of hospital stay and 30‐day readmission following heart failure hospitalization: insights from the EVEREST trial. Eur J Heart Fail 2015;17(10):1022–31.
Elasfar A, Alhabeeb W, Elasfar S. Heart Failure In The Middle East Arab Countries: Current And Future Perspectives. J Saudi Heart Assoc 2020;32(2):236–41.
Lee JH, Kim MS, Kim EJ, Park DG, Cho HJ, Yoo BS, et al. KSHF Guidelines for the Management of Acute Heart Failure: Part I. Definition, Epidemiology and Diagnosis of Acute Heart Failure. Korean Circ J 2019;49(1):1.
Ross JS, Mulvey GK, Stauffer B, Patlolla V, Bernheim SM, Keenan PS, et al. Statistical models and patient predictors of readmission for heart failure: a systematic review. Arch Intern Med 2008;168(13):1371–86.
Zaya M, Phan A, Schwarz ER. Predictors of re-hospitalization in patients with chronic heart failure. World J Cardiol 2012;4(2):23.
Schwarz KA, Elman CS. Identification of factors predictive of hospital readmissions for patients with heart failure. Heart Lung 2003;32(2):88–99.
Hasegawa K, Tsugawa Y, Camargo Jr CA, Brown DF. Frequent utilization of the emergency department for acute heart failure syndrome: a population-based study. Circ Cardiovasc Qual Outcomes 2014;7(5):735–42.
Zaya M, Phan A, Schwarz ER. The dilemma, causes and approaches to avoid recurrent hospital readmissions for patients with chronic heart failure. Heart Fail Rev 2012;17(3):345–53.
Akkineni SSL, Mohammed O, Pathiraj JPK, Devasia T, Chandrababu R, Kunhikatta V. Readmissions and clinical outcomes in heart failure patients: A retrospective study. Clin Epidemiol Glob Health 2020;8(2):495–500.
Hobbs FDR, Doust J, Mant J, Cowie MR. Diagnosis of heart failure in primary care. Heart 2010;96(21):1773–7.
Philbin EF, DiSalvo TG. Prediction of hospital readmission for heart failure: development of a simple risk score based on administrative data. J Am Coll Cardiol 1999;33(6):1560–6.
Krumholz HM, Parent EM, Tu N, Vaccarino V, Wang Y, Radford MJ, et al. Readmission after hospitalization for congestive heart failure among Medicare beneficiaries. Arch Intern Med 1997;157(1):99–104.
Komajda M, Hanon O, Hochadel M, Lopez-Sendon JL, Follath F, Ponikowski P, et al. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II. Eur Heart J 2009;30(4):478–86.
Mahjoub H, Rusinaru D, Soulière V, Durier C, Peltier M, Tribouilloy C. Long‐term survival in patients older than 80 years hospitalised for heart failure. A 5‐year prospective study. Eur J Heart Fail 2008;10(1):78–84.
Komajda M, Hanon O, Hochadel M, Follath F, Swedberg K, Gitt A, et al. Management of octogenarians hospitalized for heart failure in Euro Heart Failure Survey I. Eur Heart J 2007;28(11):1310–8.
Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol 1974;34:29–34.
Held C, Gerstein H, Yusuf S, Zhao F, Hilbrich L, Anderson C, et al. Glucose levels predict hospitalization for congestive heart failure in patients at high cardiovascular risk. Circulation 2007;115(11):1371–5.
Iribarren C, Karter AJ, Go AS, Ferrara A, Liu JY, Sidney S, et al. Glycemic control and heart failure among adult patients with diabetes. Circulation 2001;103(22):2668–73.
Turnbull F, Abraira C, Anderson R, Byington R, Chalmers J, Duckworth W, et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 2009;52:2288–98.
Heusch G. Heart Rate and Heart Failure–Not a Simple Relationship. Circ J 2011;75(2):229–36.
Böhm M, Swedberg K, Komajda M, Borer JS, Ford I, Dubost-Brama A, et al. Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trial. Lancet Lond Engl 2010;376(9744):886–94.
Ahmadi-Kashani M, Kessler DJ, Day J, Bunch TJ, Stolen KQ, Brown S, et al. Heart rate predicts outcomes in an implantable cardioverter-defibrillator population. Circulation 2009;120(21):2040–5.
Konishi M, Haraguchi G, Kimura S, Inagaki H, Kawabata M, Hachiya H, et al. Comparative effects of carvedilol vs bisoprolol for severe congestive heart failure. Circ J 2010;74(6):1127–34.
Metra M, Torp-Pedersen C, Swedberg K, Cleland JGF, Di Lenarda A, Komajda M, et al. Influence of heart rate, blood pressure, and beta-blocker dose on outcome and the differences in outcome between carvedilol and metoprolol tartrate in patients with chronic heart failure: results from the COMET trial. Eur Heart J 2005;26(21):2259–68.
Uthamalingam S, Patvardhan EA, Subramanian S, Ahmed W, Martin W, Daley M, et al. Utility of the Neutrophil to Lymphocyte Ratio in Predicting Long-Term Outcomes in Acute Decompensated Heart Failure. Am J Cardiol 2011;107(3):433–8.
Benites-Zapata VA, Hernandez AV, Nagarajan V, Cauthen CA, Starling RC, Wilson Tang WH. Usefulness of Neutrophil-to-Lymphocyte Ratio in Risk Stratification of Patients with Advanced Heart Failure. Am J Cardiol 2015;115(1):57–61.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Muhammad Saleem Awan, Muhammad Khaleel Iqbal, Matiullah Khan, Danish Naveed, Rukhshanda Afsar, Shaista Jalil
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
