Predictors of readmission in hospitalized heart failure patients

Area of Science:

• Cardiology
• Internal Medicine
• Healthcare Management

Background:

• Heart failure (HF) hospitalizations represent a significant healthcare cost.
• Persistent high readmission rates underscore the need for improved HF management strategies.
• Understanding predictors of readmission is crucial for reducing healthcare burden and improving patient prognosis.

Purpose of the Study:

• To determine the prevalence of early readmission in patients hospitalized with heart failure.
• To identify clinical, paraclinical, and imaging predictors associated with early and late readmissions.
• To assess in-hospital and 6-month post-discharge mortality rates.

Main Methods:

• A cohort of 428 patients diagnosed with heart failure between April 2018 and August 2018 was retrospectively analyzed.
• Data collected included clinical, paraclinical, and imaging parameters.
• Patients were followed for 6 months to track readmissions, mortality, and identify predictive factors.

Main Results:

• The overall readmission rate was 24% (99 patients), with 6.6% (27 patients) experiencing early (30-day) readmission.
• Significant predictors of readmission included older age, lower left ventricular ejection fraction (LVEF), higher body weight, ICD/CRT implantation, lower serum sodium, elevated Pro-BNP, higher White Blood Cell (WBC) count, and increased Blood Urea Nitrogen (BUN) levels.
• Independent predictors of early readmission were history of device implantation, lower LVEF, QRS duration >120 ms, higher BUN, higher Pro-BNP, and higher uric acid levels. In-hospital and 6-month mortality rates were 11% and 14.4%, respectively.

Conclusions:

• Predictors of early heart failure readmission are multifactorial, involving cardiac function, patient characteristics, and prior interventions.
• Lower LVEF, device implantation history, and elevated biomarkers like Pro-BNP and BUN are critical indicators for early readmission risk.
• Targeting these factors, especially in a population with younger heart failure patients and high ischemic cardiomyopathy prevalence, can inform strategies to reduce readmissions and improve long-term outcomes.