title: Predictors of rehospitalization in patients admitted with heart failure in Abeokuta, Nigeria: data from the Abeokuta heart failure registry.
abstract: OBJECTIVE
  We sought, for the first time, to examine the rate and predictors of hospital readmission in patients discharged after an episode of heart failure (HF) in Nigeria.
  
  
  METHODS
  This was a hospital-based, prospective, observational study that used the data from the Abeokuta HF Registry.
  
  
  RESULTS
  Overall, 1.53% (95% confidence interval [CI] 0.58-4.02) and 12.2% (95% CI 8.88-16.8) of patients were re-hospitalized at least once within 30 days and 6 months, respectively (5.3% had multiple readmissions); the latter comprised 21/138 men (15.2%) and 11/124 (8.9%) women. A total of 11 (4.2%) died (all of whom had been rehospitalized). Worsening HF (24 cases, 75%) was the commonest reason for readmission. Among others, factors associated with rehospitalization included presence of mitral regurgitation (odds ratio [OR] 2.37, 95% CI 1.26-4.46), age ≥ 60 years (OR 2.04, 95% CI 0.96-3.29), presence of tricuspid regurgitation (OR 1.77, 95% CI 0.86-3.61), and presence of atrial fibrillation (OR 1.34, 95% CI 0.59-3.03). However, on an adjusted basis, only female sex (adjusted OR 0.33, 95% CI 0.14-0.79; P = .014 vs male) and body mass index <19 kg/m² (adjusted OR 3.74, 95% CI 1.15-12.16; P = .028 vs ≥ 19 kg/m²) were independent correlates of readmission during 6 months' follow-up.
  
  
  CONCLUSIONS
  HF rehospitalization within 6 months' follow-up occurred in ∼12% of our cohort living an environment where HF etiology is predominately nonischemic and the HF population is relatively younger. Higher rates of readmission were noted in those with older age, lower body mass index, low literacy, lower serum sodium level, and presence of atrial fibrillation, renal dysfunction, and valvular dysfunction.
authors.affiliation: Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria; Soweto Cardiovascular Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa. Electronic address: osogah56156@yahoo.com.
authors.forename: Okechukwu S
authors.initials: OS
authors.lastname: Ogah
authors.affiliation: Soweto Cardiovascular Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa; NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: Ayodele O
authors.initials: AO
authors.lastname: Falase
authors.affiliation: Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria.
authors.forename: Joshua O
authors.initials: JO
authors.lastname: Akinyemi
authors.affiliation: Department of Medicine, Sacred Heart Hospital, Lantoro, Abeokuta, Nigeria.
authors.forename: Gail D
authors.initials: GD
authors.lastname: Adegbite
authors.affiliation: Department of Medicine, Sacred Heart Hospital, Lantoro, Abeokuta, Nigeria.
authors.forename: Albert A
authors.initials: AA
authors.lastname: Alabi
authors.affiliation: Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.
authors.forename: Akinlolu A
authors.initials: AA
authors.lastname: Ajani
authors.affiliation: Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.
authors.forename: Julius O
authors.initials: JO
authors.lastname: Adesina
authors.affiliation: Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.
authors.forename: Amina
authors.initials: A
authors.lastname: Durodola
authors.affiliation: Soweto Cardiovascular Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa; Department of Medicine, Hatter Institute for Cardiovascular Research in Africa and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa
mesh_terms: D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010359:Patient Readmission / Q000639:trends*; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014505:Urban Population
keywords: Heart failure; Nigeria; outcome; predictors; rehospitalization; survival