TY - JOUR
T1 - Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure
AU - Delgado, Juan F.
AU - Ferrero Gregori, Andreu
AU - Fernández, Laura Morán
AU - Claret, Ramón Bascompte
AU - Sepúlveda, Andrés Grau
AU - Fernández-Avilés, Francisco
AU - González-Juanatey, José R.
AU - García, Rafael Vázquez
AU - Otero, Miguel Rivera
AU - Segovia Cubero, Javier
AU - Pascual Figal, Domingo
AU - Crespo-Leiro, Maria G.
AU - Alvarez-García, Jesús
AU - Cinca, Juan
AU - Ynsaurriaga, Fernando Arribas
N1 - Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: Identifying readmission predictors in heart failure (HF) patients may help guide preventative efforts and save costs. We aimed to identify 15- and 30-day readmission predictors due to cardiovascular reasons. Methods and Results: A total of 1831 patients with acute HF admission were prospectively followed during a year. Patient-associated variables were gathered at admission/discharge and events during follow-up. A multivariate Fine and Gray competing risk regression model and a cumulative incidence function were used to identify predictors and build a risk score model for 15- and 30-day readmission. The 15- and 30-day readmission rates due to cardiovascular reasons were 7.1% and 13.9%. Previous acute myocardial infarction, congestive signs at discharge, and length of stay > 9 days were predictors of 15- and 30-day readmission, while much weight loss and large NT-ProBNP reduction were protective factors. The NT-ProBNP reduction was larger at 30 days (> 55%) vs 15 days (> 40%) to protect from readmission. Glomerular filtration rate at discharge < 60 mL/min/1.73m2 and > 1 previous admissions due to HF were predictors of 30-day readmission, while first post-discharge control at an HF unit was a protective factor. Conclusions: Previous identified factors for early readmission were confirmed. The NT-ProBNP reduction should be increased (> 55%) to protect from 30-day readmission.
AB - Background: Identifying readmission predictors in heart failure (HF) patients may help guide preventative efforts and save costs. We aimed to identify 15- and 30-day readmission predictors due to cardiovascular reasons. Methods and Results: A total of 1831 patients with acute HF admission were prospectively followed during a year. Patient-associated variables were gathered at admission/discharge and events during follow-up. A multivariate Fine and Gray competing risk regression model and a cumulative incidence function were used to identify predictors and build a risk score model for 15- and 30-day readmission. The 15- and 30-day readmission rates due to cardiovascular reasons were 7.1% and 13.9%. Previous acute myocardial infarction, congestive signs at discharge, and length of stay > 9 days were predictors of 15- and 30-day readmission, while much weight loss and large NT-ProBNP reduction were protective factors. The NT-ProBNP reduction was larger at 30 days (> 55%) vs 15 days (> 40%) to protect from readmission. Glomerular filtration rate at discharge < 60 mL/min/1.73m2 and > 1 previous admissions due to HF were predictors of 30-day readmission, while first post-discharge control at an HF unit was a protective factor. Conclusions: Previous identified factors for early readmission were confirmed. The NT-ProBNP reduction should be increased (> 55%) to protect from 30-day readmission.
KW - Heart failure
KW - NT-ProBNP
KW - Predictive factors
KW - Readmission
UR - http://www.scopus.com/inward/record.url?scp=85076210853&partnerID=8YFLogxK
U2 - 10.1007/s11897-019-00442-1
DO - 10.1007/s11897-019-00442-1
M3 - Article
C2 - 31768916
AN - SCOPUS:85076210853
SN - 1546-9530
VL - 16
SP - 304
EP - 314
JO - Current Heart Failure Reports
JF - Current Heart Failure Reports
IS - 6
ER -