Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (4): 63-69.doi: 10.6040/j.issn.1671-7554.0.2020.1439

Previous Articles     Next Articles

Readmission prediction of 152 non-selective adult patients with chronic heart failure

LAN Hongtao1,2, JIA Xu3,4, TONG Zhoujie3,4, ZHENG Man5, HU Boang3,4, ZHONG Ming3,4, ZHANG Wei3,4, WANG Zhihao1,2   

  1. 1. Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Shandong Key Laboratory of Cardiovascular Proteomics, Jinan 250012, Shandong, China;
    3. Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    4. Key Laboratory of Cardiovascular Remodeling and Function, Ministry of Education and National Health Commission, Jinan 250012, Shandong, China;
    5. Department of Cardiology, Dongying People s Hospital, Dongying 257100, Shandong, China
  • Published:2021-04-30

PDF (PC)

353

Abstract: Objective To explore the influencing factors of readmission of patients with chronic heart failure(CHF). Methods A total of 152 CHF cases treated during May 2016 and Dec. 2018 were enrolled in this retrospective study, including 107 males and 45 females, age 26 to 93 years, average 70.95±14.08 years. Statistical analyses of clinical indicators, laboratory tests and drug use were performed with SPSS 20.0 software. CHF patients were divided into recurrence and non-recurrence groups for bivariate Logistic regression analysis. The readmission interval of patients with multiple admissions was analyzed with linear regression analysis. Results The recurrence rate of CHF was 58.6%. Compared with the non-recurrence group, the recurrence group tended to have a history of coronary heart disease(CHD), abnormal NT-proBNP and creatinine level, and no consumption of angiotensin converting enzyme inhibitor(ACEI)drugs, and the differences were statistically significant(P<0.05). Bivariate Logistic regression analysis revealed history of CHD(OR=3.728, 95%CI=1.902-7.308), use of digoxin(OR=1.320, 95%CI=1.034-1.686)and abnormal NT-proBNP(OR=4.854, 95%CI=2.010-11.723)were risk factors of recurrence, while increased diastolic blood pressure(DBP)(OR=0.982,95%CI=0.971-0.993)was a protective factor. Linear regression analysis showed age(β=-1.501, P=0.001)and history of diabetes(β=-0.810, P=0.036)were negatively correlated with the interval of readmission; gender(β=1.231, P=0.001), heart rate(HR, β=1.546, P=0.001), and taking of aspirin(β=0.477, P=0.001)were associated with prolonged interval of readmission. Conclusion There is a nonstandard administration of CHF patients and the recurrence rate is high. NT-proBNP, heart rate and diastolic blood pressure should be closely monitored to reduce the recurrence rate of CHF.

Key words: Chronic heart failure, Readmission rate, Recurrence, Interval of readmission

CLC Number: 

  • R541.6
[1] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心力衰竭和心肌病杂志, 2018(4): 196-225.
[2] 胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要[J]. 中国循环杂志, 2019, 34(3): 209-220.
[3] Bottle A, Honeyford K, Chowdhury F, et al. Factors associated with hospital emergency readmission and mortality rates in patients with heart failure or chronic obstructive pulmonary disease: a national observational study [J]. Southampton(UK): NIHR Journals, 2018. doi: 10.3310/hsdr06260.
[4] Jencks SF. Rehospitalizations among patients in the medicare fee-for-service program [J]. N Engl J Med, 2009, 360(14): 1418-1428.
[5] 吕金如, 胡德亮, 张刚, 等. 慢性心力衰竭住院患者的临床特征分析[J]. 南京医科大学学报(自然科学版), 2016, 36(12): 1475-1477. LYU Jinru, HU Deliang, ZHANG Gang, et al. Analysis of clinical characteristics of inpatients with chronic heart failure [J]. Acta Universitatis Medicinalis Nanjing, 2016, 36(12): 1475-1477.
[6] 欧邦豪, 张圳锋, 林桂娥, 等. 不同年龄老年慢性心力衰竭患者临床特征分析[J]. 慢性病学杂志, 2018, 19(5): 532-535. OU Banghao, ZHANG Zhenfeng, LIN Guie, et al. Clinical characteristics of elderly patients withchronic heart failure in different ages [J]. Chronic Pathematology Journal, 2018, 19(5): 532-535.
[7] Deek H, Skouri H, Noureddine S. Readmission rates and related factors in heart failure patients: a study in Lebanon [J]. Collegian, 2016, 23(1): 61-68.
[8] 胡安新, 徐冬梅, 周华, 等. 120例慢性心力衰竭患者再住院率现状调查分析[J]. 中国医院药学杂志, 2015, 35(1): 71-76. HU Anxin, XU Dongmei, ZHOU Hua, et al. Investigation and analysis of rehospitalization rate of 120 patients with chronic heart failure [J]. Chinese Journal of Hospital Pharmacy, 2015, 35(1): 71-76.
[9] 何文学. 慢性心力衰竭患者再入院的影响因素分析[J]. 深圳中西医结合杂志, 2015, 25(2): 32-33. HE Wenxue. Factors influencing readmission in patients with chronic heart failure [J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2015, 25(2): 32-33.
[10] Ruigomez A, Michel A, Martin-Perez M, et al. Heart failure hospitalization:an important prognostic factor for heart failure readmission and mortality[J]. Int J Cardiol, 2016, 220: 855-861. doi: 10.1016/j.ijcard.2016.06.080.
[11] 石爽. 南阳市宛城2015—2017年老年慢性患者再入院影响因素分析[J]. 中国老年保健医学, 2019, 17(1): 95-97. SHI Shuang. Analysis on the influencing factors of readmission of elderly chronic patients in Wancheng, Nanyang City, 2015-2017 [J]. Chinese Journal of Geriatric Care, 2019, 17(1): 95-97.
[12] Miller AJ,Arnold AC. The renin-angiotensin system in cardiovascular autonomic control:recent developments and clinical implications [J]. Clin Auton Res, 2019, 29(2): 231-243.
[13] Pinargote P, Guillen D, Guarderas JC. ACE inhibitors: upper respiratory symptoms [J]. BMJ Case Rep, 2014, 2014: bcr2014205462. doi: 10.1136/bcr-2014-205462.
[14] Kostis WJ, Shetty M, Chowdhury YS, et al. ACE inhibitor-induced angioedema: a review [J]. Curr Hypertens Rep, 2018, 20(7): 55.
[15] 陈源源. 高血压合理用药指南解读——药物治疗篇[J]. 中国医学前沿杂志(电子版), 2016, 8(2): 2-5.
[16] Omar HR, Guglin M. Post-discharge rise in BNP and rehospitalization for heart failure [J]. Herz, 2019, 44(5): 450-454.
[17] Dreyer RP, Dharmarajan K, Hsieh AF, et al. Sex differences in trajectories of risk after rehospitalization for heart failure,acute myocardial infarction,or pneumonia [J]. Circ Cardiovasc Qual Outcomes, 2017, 10(5): e003271.
[18] Rørth R, Fosbøl EL, Mogensen UM, et al. Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure [J]. Eur J Heart Fail Eur J Heart Fail, 2018, 20(2): 240-247.
[19] Gheorghiade M, Van Veldhuisen DJ, Colucci WS. Contemporary use of digoxin in the management of cardiovascular disorders [J]. Circ, 2006, 113(21): 2556-2564.
[20] Omara NB,Zimmerman WB. Withdawal of digoxin from patients with chronic heart-failure treated with angiotensin-converting enzyme-inhibitors [J]. N Engl J Med, 1993, 329(24): 1819-1820.
[21] Davila LA, Weber K, Bavendiek U, et al. Digoxin-mortality:randomized vs. observational comparison in the DIG trial [J]. Eur Heart J, 2019, 40(40): 3336-3341.
[22] Lee JH, Lee JW, Youn YJ, et al. Prognostic impact of preexisting hypertension and high systolic blood pressure at admission in patients hospitalized for systolic heart failure [J]. J Cardiol, 2016, 67(5-6): 418-423.
[23] Rahman F, Alrifai M, Blaha MJ, et al. Relation of diastolic blood pressure and coronary artery calcium to coronary events and outcomes(from the multi-ethnic study of atherosclerosis)[J]. Am J Cardiol, 2017, 120(10): 1797-1803.
[24] Macdonald MR, Jhund PS, Petrie MC, et al. Discordant short- and long-term outcomes associated with diabetes in patients with heart failure: importance of age and sex a population study of 5.1 million people in Scotland [J]. Circ Heart Fail, 2008, 1(4): 234-241.
[25] Laskey WK, Alomari I, Cox M, et al. Heart rate at hospital discharge in patients with heart failure is associated with mortality and rehospitalization [J]. J Am Heart Assoc, 2015, 4(4): e001626.
[26] Xin Y, Chen X, Zhao Y, et al. The impact of heart rate on patients diagnosed with heart failure with mid-range ejection fraction [J]. Anatol J Cardiol, 2019, 21(2): 68-74.
[1] ZUO Liping, JIANG Fengyang, ZHOU Binbin, FAN Jinlei, LIANG Yongfeng, DENG Zhanhao, YU Dexin. Value of preoperative multiphase MRI for predicting microvascular invasion and early recurrence of 169 hepatocellular carcinoma [J]. Journal of Shandong University (Health Sciences), 2022, 60(3): 89-95.
[2] XIE Tonghui, CHEN Zhiqiang, CHANG Jianhua, ZHAO Danwen, XU Bowen, ZHI Xuting. Analysis of prognostic factors after radical resection of intrahepatic cholangiocarcinoma and establishment of a nomogram [J]. Journal of Shandong University (Health Sciences), 2021, 59(4): 93-99.
[3] SONG Zhenzhen, SUN Xiaoling, LI Haiou, WANG Fang, ZHANG Ran, YU Dexin. Value of MRI radiomics of glioma and peritumoral edema in evaluating tumor recurrence [J]. Journal of Shandong University (Health Sciences), 2021, 59(11): 53-60.
[4] WU Mengtao, WU Peng, YANG Yanfei, TANG Dianjun, MIAO Xiangling, LI Fandong. Application of CT venography in the diagnosis and treatment of recurrent lower extremity varicose veins [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 21-26.
[5] ZHANG Chuanbei, LI Fang, ZHAI Chunxiao, YU Yongming, SHU Minglei, WANG Yidan, XU Liangdong, HAO Enkui. Gaussian process model for risk assessment of readmission for patients with chronic heart failure within one year [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 28-33.
[6] CHEN Linlin, YI Shaolei, WANG Weizong, LI Zhan, ZHANG Yong, ZHANG Yujiao,REN Manyi, XIE Xinxing, LIU Tongbao, HOU Yinglong. Risk factors of recurrent atrial fibrillation after radiofrequency catheter ablation [J]. Journal of Shandong University (Health Sciences), 2019, 57(3): 49-57.
[7] LI Fan, SHAO Jianhua, ZHAO Hongyu, DOU Chunhui, LÜ Yahui, LI Daqi. Clinical features and prognosis of adult secondary hemophagocytic syndrome: an analysis of 32 cases [J]. Journal of Shandong University (Health Sciences), 2019, 57(12): 62-67.
[8] MI Chuanxiao, LIU Junni, ZOU Chengwei, ZHOU Nannan. Levels of soluble suppression of tumorigenicity 2 and galectin-3 as predictors of the classification and prognosis of chronic heart failure [J]. Journal of Shandong University (Health Sciences), 2019, 57(1): 62-67.
[9] WANG Jinhui, YANG Jiaxin, YUAN Zhen, CAO Dongyan, SHEN Keng, HUANG Huifang, WU Ming, PAN Lingya, GUO Lina. Preserve fertility in recurrent and uncontrolled malignant ovarian germ cell tumors [J]. Journal of Shandong University (Health Sciences), 2018, 56(5): 35-40.
[10] ZHOU Huimei, YANG Jiaxin, CAO Dongyan, SHEN Keng, XIANG Yang, WU Ming, PAN Lingya, HUANG Huifang, LANG Jinghe. Fertility-sparing radical trachelectomy for young women with early stage cervical cancer: surgical and obstetrical outcomes [J]. Journal of Shandong University (Health Sciences), 2018, 56(5): 18-22.
[11] YU Mei, YANG Jiaxin, CAO Dongyan, WANG Yao, SHEN Keng. Diagnosis and management in patients with recurrent stage I endometrial cancer after primary fertility-preserving treatment [J]. Journal of Shandong University (Health Sciences), 2018, 56(5): 23-29.
[12] WANG Runmei, YANG Qiuhong, ZHANG Fang, MA Yuyan. Long-term prognosis of women preeclampsia and risks of incidence in their female offspring [J]. Journal of Shandong University (Health Sciences), 2017, 55(12): 31-35.
[13] LI Guangchun1, SI Zhiwen1, WU Honglei1, ZHOU Chengjun2, ZHU Kongxi1, LIU Bin1, GUO Jianqiang1. Screening of high-risk population after endoscopic polypectomy of colorectal adenomatous polyps [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(3): 92-95.
[14] CHEN Dong-chang, GU Ying, LU Ke-feng. Changes of serum high sensitivity of troponin T concentration and its clinical significance in chronic heart failure [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(2): 69-72.
[15] YANG Yang1,2, DU Wen-jun2, SHI Zhao-zhang2, ZHENG Zhao-min2, CHEN Shi-jun2. Risk factors of recurrence and survival time for single small liver cancer after percutaneous microwave coagulation therapy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(1): 89-94.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] ZHENG Min,HAO Yue-wei,LIU Xue-ping,ZHAO Ting-ting. Relationship between the HPA-2 and Kozak sequence polymorphism of platelet membrane glycoprotein and cerebral infarction[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(3): 292 -295 .
[2] ZHANG Jie,LI Zhen-hua,SUN Jin-hao,BAO Li-hua,LIU Yue-peng. Protective effects of the invariable magnetic field on oxidative injured Schwann cells[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(3): 229 -232 .
[3] WANG Shu-qin,QI Feng,WU Jian-bo,SUN Bao-zhu. Effect of calcium in ropivacaine-induced smooth muscle contraction of the aorta in rats in vitro[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(8): 773 -776 .
[4] TENG Xue-ren,ZHAO Yong-sheng,HU Guang-liang,ZHOU Lun,LI Jian-min. Characteristics of microcosmic changes following tendon allograft transplantation preserved by two methods under light microscopy and transmission electron microscopy[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(10): 945 -950 .
[5] . [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(10): 995 .
[6] JIANG Hong-ju,LI Run-zhi, WANG Ying,XU Dong-mei,ZHANG Mei,ZHANG Yun,LI Ji-fu. Relationship between the plasma level of matrix metalloproteinase-9 and structural characteristics of plaques and percutaneous coronary intervention [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(10): 966 -970 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(8): 828 -830 .
[8] . [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(9): 5 -6 .
[9] NIU Rui,LIU Bo,SHAO Ming-ju,WANG Wei. mRNA expression of lunx in regional lymph nodes of non-small cell lung cancer and its correlation with prognosis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(9): 884 -885 .
[10] WU Min,ZHAO Zhi-lun,WANG Jie-zhen. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(11): 1146 -1149 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd