Factors affecting hospital readmission heart failure patients in Japan: a multicenter retrospective cohort study

Heart Vessels. 2020 Mar;35(3):367-375. doi: 10.1007/s00380-019-01500-3. Epub 2019 Sep 13.

Abstract

The purpose of this study was to examine factors influencing readmission to hospital in patients with heart failure. This multicenter, retrospective cohort study analyzed 197 heart failure patients admitted to the research cooperation facilities between January 2017 and November 2017. We defined the readmission group as being readmitted to hospital in ≤ 6 months of discharge and the non-readmission group as > 6 months after discharge. Cox proportional hazards analysis was performed to explore the predictors of readmission. The incidence of readmission was calculated using Kaplan-Meier curves for the extracted factors. Intergroup differences were estimated using the log-rank test. The results of Cox proportional hazards analysis indicated that chronic renal dysfunction (hazard ratio (HR) = 4.729), dementia (HR = 7.105), HFrEF (HR = 8.138), walking without support (HR = 4.031), and walking with a cane (HR = 11.857) significantly contributed to the model. In the survival analyses using the Kaplan-Meier log-rank test, chronic renal dysfunction, dementia, and HFrEF were significant (P < 0.05), but walking without support and walking with a cane after discharge were not significant (P > 0.05). This study suggests that early involvement after discharge is important for lowering the readmission rates in patients with heart failure, even when their walking ability is good.

Keywords: Cox proportional hazards analysis; Heart failure; Japan; Readmission; Walking ability.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Dementia / epidemiology
  • Dependent Ambulation
  • Exercise Tolerance
  • Female
  • Gait
  • Geriatric Assessment
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Humans
  • Japan / epidemiology
  • Male
  • Mobility Limitation
  • Patient Discharge
  • Patient Readmission*
  • Recovery of Function
  • Renal Insufficiency, Chronic / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Ventricular Function, Left