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

  • Juan F. DelgadoEmail author
  • Andreu Ferrero Gregori
  • Laura Morán Fernández
  • Ramón Bascompte Claret
  • Andrés Grau Sepúlveda
  • Francisco Fernández-Avilés
  • José R. González-Juanatey
  • Rafael Vázquez García
  • Miguel Rivera Otero
  • Javier Segovia Cubero
  • Domingo Pascual Figal
  • Maria G. Crespo-Leiro
  • Jesús Alvarez-García
  • Juan Cinca
  • Fernando Arribas Ynsaurriaga
Decompensated Heart Failure (P Banerjee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Decompensated Heart Failure

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.

Keywords

Heart failure Readmission Predictive factors NT-ProBNP 

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

Notes

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.

Authors’ Contribution

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.

Funding Information

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

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Juan F. Delgado
    • 1
    • 2
    Email author
  • Andreu Ferrero Gregori
    • 3
    • 4
  • Laura Morán Fernández
    • 1
  • Ramón Bascompte Claret
    • 5
    • 6
  • Andrés Grau Sepúlveda
    • 7
  • Francisco Fernández-Avilés
    • 2
    • 8
  • José R. González-Juanatey
    • 9
    • 10
  • Rafael Vázquez García
    • 11
  • Miguel Rivera Otero
    • 12
  • Javier Segovia Cubero
    • 13
  • Domingo Pascual Figal
    • 14
    • 15
  • Maria G. Crespo-Leiro
    • 16
  • Jesús Alvarez-García
    • 3
  • Juan Cinca
    • 3
    • 17
  • Fernando Arribas Ynsaurriaga
    • 1
    • 2
  1. 1.Cardiology Department, University Hospital 12 de OctubreInstituto de Investigación Sanitaria Hospital 12 de Octubre (imas12)MadridSpain
  2. 2.CIBERCV; Facultad de MedicinaUniversidad Complutense de MadridMadridSpain
  3. 3.Cardiology DepartmentUniversity Hospital Santa Creu i Sant PauBarcelonaSpain
  4. 4.Facultad de MedicinaUniversitat Autònoma de BarcelonaBarcelonaSpain
  5. 5.Cardiology DepartmentHospital Universitari Arnau de VilanovaLleidaSpain
  6. 6.IRBLLEIDALleidaSpain
  7. 7.Cardiology DepartmentUniversity Hospital Son EspasesPalma de MallorcaSpain
  8. 8.Cardiology DepartmentUniversity Hospital Gregorio MarañónMadridSpain
  9. 9.CIBERCV; Cardiology DepartmentUniversity Hospital Santiago de CompostelaSantiago de CompostelaSpain
  10. 10.Facultad de MedicinaUniversidad de SantiagoSantiago de CompostelaSpain
  11. 11.Cardiology DepartmentUniversity Hospital Puerta del MarCádizSpain
  12. 12.CIBERCV; Cardiology DepartmentUniversity Hospital La FeValenciaSpain
  13. 13.CIBERCV; Cardiology DepartmentUniversity Hospital Puerta de Hierro-MajadahondaMadridSpain
  14. 14.CIBERCV; Cardiology DepartmentUniversity Hospital Virgen de la ArrixacaMurciaSpain
  15. 15.Facultad de MedicinaUniversidad de MurciaMurciaSpain
  16. 16.CIBERCV; University Hospital de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC)Universidad de A Coruña (UDC)A CoruñaSpain
  17. 17.Facultad de MedicinaUniversitat Autònoma de BarcelonaBarcelonaSpain

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