Evaluation of factors associated with 30-day readmission in patients with heart failure

Introduction & Objective: Although several studies have been conducted to identify the factors associated with readmission of patients with heart failure, statistics still show a high readmission rate in these patients. Therefore, it is necessary to identify the readmission-related patterns and factors in order to reduce the costs of health system and other complications, and also make plan to reduce the readmission rate. Therefore, this study was conducted to investigate the factors associated with 30-day readmission of patients with heart failure.

Methods: This is a retrospective single-center study, which was conducted on all patients with heart failure (312 patients) admitted to Shahid Chamran Heart Hospital in Isfahan. Sampling took place in 1^st April and lasted to 22^nd September 2019. The medical records of these patients were reviewed and then, they were followed-up for 6 months after the initial hospitalization, in terms of 30-day readmission and non-readmission at the same medical center. The information of patients was collected by a researcher-made data collection form and then, demographic characteristics, clinical conditions, common drug treatments and discharge conditions of patients were compared in two groups and analyzed by inferential statistics.

Results: The rate of 30-day readmission among the entire samples was 7.4% (23 out of 312) and the rate of over 30-day readmission was 0.17% (53 out of 312). The results showed a significant relationship between body mass index, as one of the clinical indicators, and the rate of 30-day readmission (²x₍₃₎ =8.57, P=0.036). There was also a significant relationship between diuretic drug treatment and 30-day readmission (²x₍₃₎ = 5.91, P = 0.015). The chance of 30-day readmission in patients treated with diuretics was 4.2 times higher than those who did not receive diuretics (OR=4.24, 95%, CI: 1.02 – 17.64). A statistically significant relationship was also observed between the mean systolic blood pressure (t ₍₃₁₀₎ =3.57, P <0.001, diastolic blood pressure (t ₍₃₁₀₎ = 2.26, P = 0.024) and 30-day readmission rate.

Conclusion: Based on the findings, follow-up treatment and care is very important in patients with heart failure treated with diuretics, as well as patients with high body mass index and decreased systolic and diastolic blood pressure. Developing a post-discharge care plan for patients can be effective in reducing the rate of 30-day readmission.

Keywords: Heart failure, 30-day readmission, Clinical condition, Drug treatment, Discharge condition