Multi-Trajectories of Symptoms and their Associations with Unplanned 30-day Hospital Readmission among Patients with Heart Failure: A longitudinal study

Qingyun Lv; Xiaonan Zhang; Yaqi Wang; Xueying Xu; Yuan He; Jingwen Liu; Hairong Chang; Xiaoying Zang; Yue Zhao

doi:10.1093/eurjcn/zvae038

Multi-Trajectories of Symptoms and their Associations with Unplanned 30-day Hospital Readmission among Patients with Heart Failure: A longitudinal study

Eur J Cardiovasc Nurs. 2024 Mar 20:zvae038. doi: 10.1093/eurjcn/zvae038. Online ahead of print.

Authors

Qingyun Lv¹, Xiaonan Zhang¹, Yaqi Wang¹, Xueying Xu¹, Yuan He¹, Jingwen Liu¹, Hairong Chang¹, Xiaoying Zang¹, Yue Zhao¹

Affiliation

¹ Tianjin Medical University, School of Nursing, Tianjin, Peoples R China.

PMID: 38507650
DOI: 10.1093/eurjcn/zvae038

Abstract

Aims: This study aimed to uncover hidden patterns and predictors of symptom multi-trajectories within 30 days after discharge in patients with heart failure and assess the risk of unplanned 30-day hospital readmission in different patterns.

Methods and results: The study was conducted from September 2022 to September 2023 in four third-class hospitals in Tianjin, China. A total of 301 patients with heart failure were enrolled in the cohort, and 248 patients completed a 30-day follow-up after discharge. Three multi-trajectory groups were identified: mild symptom status (24.19%), moderate symptom status (57.26%), and severe symptom status (18.55%). With the mild symptom status group as a reference, physical frailty, psychological frailty, and comorbid renal dysfunction were predictors of the moderate symptom status group. Physical frailty, psychological frailty, resilience, taking diuretics, and comorbid renal dysfunction were predictors of the severe symptom status group. Compared with the mild symptom status group, the severe symptom status group was significantly associated with high unplanned 30-day hospital readmission risks.

Conclusions: This study identified three distinct multi-trajectory groups among patients with heart failure within 30 days after discharge. The severe symptom status group was associated with a significantly increased risk of unplanned 30-day hospital readmission. Common and different factors predicted different symptom multi-trajectories. Healthcare providers should assess the physical and psychological frailty and renal dysfunction of patients with heart failure before discharge. Inpatient care aimed at alleviating physical and psychological frailty and enhancing resilience may be important to improve patients' symptom development post-discharge.

Keywords: Group-based Multi-trajectory Modeling; frailty; heart failure; patient readmission; resilience; symptom assessment.

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