Effect of gender, ethnicity, pulmonary disease, and symptom stability on rehospitalization in patients with heart failure.
Predicting rehospitalization risk may enable more tailored therapies for patients at high risk of rehospitalization. The objective of this study was to determine whether demographic, clinical, or psychological variables conferred increased risk of rehospitalization in a multiethnic, hospitalized, heart failure (HF) population. Demographic and clinical data were collected, with psychological and functional (6-minute walk test [6MWT]) variables obtained within 48 hours of discharge. Patients with HF (n = 72) were followed up for 90 days after discharge. Subjects' mean age was 62 +/- 18 years, with almost 1/2 nonwhite (n = 32) and 2/3 men (n = 47). Mean discharge brain natriuretic peptide was 825 +/- 716 ng/L, mean quality-of-life score was 34 +/- 21, and mean 6MWT distance was 186 +/- 99 m. Almost 1/2 (n = 34) were rehospitalized for cardiac reasons within 90 days. Women had a 2.5 times greater risk for rehospitalization than men. Both female gender and nonwhite ethnicity incurred > or =2 times greater risk of cardiac rehospitalization. Brain natriuretic peptide and 6MWT score did not predict rehospitalization risk. In conclusion, sociodemographic factors may be more powerful predictors of rehospitalization than known clinical markers in multiethnic patients hospitalized for HF. Evaluation for support services is needed to prevent rehospitalization, especially in women and nonwhites.
Howie-Esquivel
Jill
J
Department of Physiological Nursing, University of California, San Francisco, San Francisco, California, USA. jill.howie-esquivel@nursing.ucsf.edu
Dracup
Kathleen
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000208:ethnology* / Q000628:therapy; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
D020097:Natriuretic Peptide, Brain