Incidence and predictors of rehospitalization of acute heart failure patients.
Repeated hospitalization due to acute decompensated heart failure (HF) is a pandemic health problem in Japan. However, it is difficult to predict rehospitalization after discharge for acute decompensated HF. We used a single hospital-based cohort from the Shinken Database 2004-2012, comprising all new patients (n = 19,994) who visited the Cardiovascular Institute Hospital. A total of 282 patients discharged after their first acute HF admission were included in the analysis. The median follow-up period was 908 ± 865 days. Of these patients, rehospitalization due to worsening HF occurred in 55 patients. The cumulative rate of rehospitalization was 17.5% at 1 year, 21.4% at 2 years, and 25.5% at 3 years. Patients with rehospitalization were older than those without rehospitalization. Prevalence of diabetes mellitus (DM) was more common in patients with rehospitalization. Average heart rate (HR) tended to be higher in patients with rehospitalization. Loop diuretics were more commonly used at hospital discharge in patients with rehospitalization. Multivariate Cox regression analysis revealed that age ≥ 75 years, DM, HR ≥ 75 bpm at discharge, and use of loop diuretics at discharge were independent predictors for rehospitalization. The number of these independent risk factors could be used to clearly discriminate between the HF rehospitalization low-, middle- and high-risk patients. HF rehospitalization commonly occurred in patients who were discharged after their first acute HF admission. Older age, DM, increased HR, and loop diuretics use at discharge were independently associated with HF rehospitalization. By simply counting these risk factors, we might be able to predict the risk of HF rehospitalization after discharge.
Department of Cardiovascular Medicine, The Cardiovascular Institute.
Hidehiro
H
Kaneko
Shinya
S
Suzuki
Masato
M
Goto
Takuto
T
Arita
Yasufumi
Y
Yuzawa
Naoharu
N
Yagi
Nobuhiro
N
Murata
Yuko
Y
Kato
Hiroto
H
Kano
Shunsuke
S
Matsuno
Takayuki
T
Otsuka
Tokuhisa
T
Uejima
Yuji
Y
Oikawa
Koichi
K
Sagara
Kazuyuki
K
Nagashima
Hajime
H
Kirigaya
Hitoshi
H
Sawada
Tadanori
T
Aizawa
Junji
J
Yajima
Takeshi
T
Yamashita
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013997:Time Factors
D049994:Sodium Potassium Chloride Symporter Inhibitors