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Precipitating factors and clinical impact of early rehospitalization for heart failure in patients with heart failure in Awaji Island, Japan
- Source :
- Journal of Cardiology. 77:645-651
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Recent reports have revealed that patients who experienced early rehospitalization for heart failure (HF) had worse prognoses in terms of all-cause and cardiovascular deaths as compared to those who did not. However, precipitating factors for early rehospitalization for HF remain unknown. In this study, we assessed the precipitating factors for early rehospitalization and their impact in patients with HF.We consecutively included 242 patients (mean age: 80.4 years, females: 46.3%) with a history of rehospitalization for HF. They were divided into 2 groups: the early rehospitalization group (71 patients who were readmitted within 3 months of discharge) and the late rehospitalization group (171 patients who were readmitted after more than 3 months following discharge). During the mean follow-up period of 1,144 days (range: 857-1,417 days), 121 patients (50.0%) died. Kaplan-Meier analysis revealed that patients in the early rehospitalization group had worse prognosis (all-cause death and cardiovascular death) than those in the late rehospitalization group (log-rank p0.001). As the major precipitating factor for rehospitalization, poor compliance with the doctor's instructions on fluid and physical activity restrictions (determined by the patients or their families admittance of non-compliance with the instructions given at the time of discharge) was higher in the early rehospitalization group than in the late rehospitalization group [poor compliance with fluid restriction: 19.7% vs. 7.6% (p = 0.006), poor compliance with physical activity restriction: 21.1% vs. 9.4% (p = 0.013)].We concluded that early hospital readmission in patients with HF was associated with higher mortality rates. Compared to late rehospitalization, precipitating factors for early rehospitalization were more strongly dependent on the self-care behaviors of the patients. A more effective approach, such as multidisciplinary intervention, is essential to prevent early hospital readmission and subsequent poor prognosis.
- Subjects :
- medicine.medical_specialty
Poor prognosis
030204 cardiovascular system & hematology
Patient Readmission
Cardiovascular death
03 medical and health sciences
0302 clinical medicine
Japan
Risk Factors
Internal medicine
medicine
Humans
In patient
030212 general & internal medicine
Aged, 80 and over
Heart Failure
Hospital readmission
business.industry
Mortality rate
Mean age
Precipitating Factors
medicine.disease
Heart failure
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 09145087
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....880dac389f02618dbfdf1b6f229490c7