Time to Readmission and Its Prognostic Factors among Hospitalised Heart Failure Patients

Heart failure (HF) is a common comorbidity in the adult population and a common cause of recurrent readmissions. This study aimed to determine the proportion of readmissions, the median time to readmission and its prognostic factors among hospitalised HF patients.

This is a retrospective cohort study that involved patients admitted for HF at a tertiary hospital in Kelantan, Malaysia from October 2021 to December 2022. Adult patients who underwent a formal echocardiogram within one year of the index hospitalisation were included. Patients were excluded if they had inpatient mortality or an active malignancy, if they were transferred to another facility, or if they were discharged against medical advice. They had an additional follow-up period of one year to assess the event of interest (readmission). Patients who did not experience a readmission were censored. Prognostic factors for the time to readmission were identified using multiple Cox regression analysis.

A total of 276 patients were included in the analysis, with a mean age of 60.64 years. The proportions of readmissions at six months and one year after discharge were 51.8% and 63.4%, respectively. The median time to readmission for the cohort was 118 days. Prognostic factors for the time to readmission included atrial fibrillation (AF) (adjusted hazard ratio [AHR] = 2.06; 95% confidence interval [CI] : 1.42, 2.99), chronic kidney disease (CKD) (AHR = 1.53; 95% CI: 1.14, 2.04), a low albumin level (AHR = 0.96; 95% CI: 0.94, 0.99), a high aspartate aminotransferase (AST) level (AHR = 1.003; 95% CI: 1.001, 1.006) and ejection fraction (EF) ≤ 40% (AHR = 1.37; 95% CI: 1.03, 1.84).

Most patients experienced a readmission within six months of discharge. Several factors were identified as prognostic factors for readmission. Therefore, clinicians must optimise patient care before discharge, paying special attention to these factors.