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Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure

  • Decompensated Heart Failure (P Banerjee, Section Editor)
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Abstract

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.

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Abbreviations

HF:

Heart failure

AMI:

Acute myocardial infarction

CV:

Cardiovascular

NT-proBNP:

N-terminal proB-type natriuretic peptide

LVEF:

Left ventricular ejection fraction

LOS:

Hospital length of stay

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Acknowledgments

The authors would like to thank the investigators of the Spanish Network for the Study of Heart Failure II (REDINSCOR II Registry) for their participation in the study. The authors are indebted with all of them. Medical writing services from Almudena Pardo are acknowledged.

Funding

This work was supported by the Institute of Health Carlos III through the CIBERCV and European Regional Development Fund (ERDF).

Author information

Authors and Affiliations

  1. Cardiology Department, University Hospital 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Av de Córdoba sn, 28041, Madrid, Spain

    Juan F. Delgado, Laura Morán Fernández & Fernando Arribas Ynsaurriaga

  2. CIBERCV; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

    Juan F. Delgado, Francisco Fernández-Avilés & Fernando Arribas Ynsaurriaga

  3. Cardiology Department, University Hospital Santa Creu i Sant Pau, Barcelona, Spain

    Andreu Ferrero Gregori, Jesús Alvarez-García & Juan Cinca

  4. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

    Andreu Ferrero Gregori

  5. Cardiology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain

    Ramón Bascompte Claret

  6. IRBLLEIDA, Lleida, Spain

    Ramón Bascompte Claret

  7. Cardiology Department, University Hospital Son Espases, Palma de Mallorca, Spain

    Andrés Grau Sepúlveda

  8. Cardiology Department, University Hospital Gregorio Marañón, Madrid, Spain

    Francisco Fernández-Avilés

  9. CIBERCV; Cardiology Department, University Hospital Santiago de Compostela, Santiago de Compostela, Spain

    José R. González-Juanatey

  10. Facultad de Medicina, Universidad de Santiago, Santiago de Compostela, Spain

    José R. González-Juanatey

  11. Cardiology Department, University Hospital Puerta del Mar, Cádiz, Spain

    Rafael Vázquez García

  12. CIBERCV; Cardiology Department, University Hospital La Fe, Valencia, Spain

    Miguel Rivera Otero

  13. CIBERCV; Cardiology Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain

    Javier Segovia Cubero

  14. CIBERCV; Cardiology Department, University Hospital Virgen de la Arrixaca, Murcia, Spain

    Domingo Pascual Figal

  15. Facultad de Medicina, Universidad de Murcia, Murcia, Spain

    Domingo Pascual Figal

  16. CIBERCV; University Hospital de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña (UDC), A Coruña, Spain

    Maria G. Crespo-Leiro

  17. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

    Juan Cinca

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Contributions

Juan F. Delgado takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Andreu Ferrero Gregori takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Laura Morán Fernández takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Ramón Bascompte Claret takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Andrés Grau Sepúlveda takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Francisco Fernández-Avilés takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

José R. González-Juanatey takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Rafael Vázquez García takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Miguel Rivera Otero takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Javier Segovia Cubero takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Domingo Pascual Figal takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Maria G. Crespo-Leiro takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Jesús Alvarez-García takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Juan Cinca takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Fernando Arribas Ynsaurriaga takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Corresponding author

Correspondence to Juan F. Delgado.

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Delgado, J.F., Ferrero Gregori, A., Fernández, L.M. et al. Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure. Curr Heart Fail Rep 16, 304–314 (2019). https://doi.org/10.1007/s11897-019-00442-1

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