Incidence and predictors of rehospitalization of acute heart failure patients

Hidehiro Kaneko, Shinya Suzuki, Masato Goto, Takuto Arita, Yasufumi Yuzawa, Naoharu Yagi, Nobuhiro Murata, Yuko Kato, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Tokuhisa Uejima, Yuji Oikawa, Koichi Sagara, Kazuyuki Nagashima, Hajime Kirigaya, Hitoshi Sawada, Tadanori Aizawa, Junji Yajima, Takeshi Yamashita

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

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 hospi-tal-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. Mul-tivariate 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. (Int Heart J 2015; 56: 219-225).

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalInternational Heart Journal
Volume56
Issue number2
DOIs
Publication statusPublished - 23 Feb 2015
Externally publishedYes

Keywords

  • Diabetes mellitus
  • Diuretics
  • Elderly
  • Heart rate
  • Japanese

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