Dai Shengchuan, Manoucheri Manoucher, Gui Junhong, Zhu Xiang, Malhotra Divyanshu, Li Shenjing, D'souza Jason, Virkram Fnu, Chada Aditya, Jiang Haibing
Internal Medicine Residency Program, Department of Medicine, Florida Hospital Orlando, Orlando, FL, USA; Division of Cardiology, University of Illinois at Chicago, Chicago, IL, USA.
Internal Medicine Residency Program, Department of Medicine, Florida Hospital Orlando, Orlando, FL, USA.
Cardiol Res Pract. 2016;2016:4571201. doi: 10.1155/2016/4571201. Epub 2016 Oct 30.
. Heart failure (HF) is one of the most common diagnoses associated with hospital readmission. We designed this prospective study to evaluate whether Kansas City Cardiomyopathy Questionnaire (KCCQ) score is associated with 30-day readmission in patients hospitalized with decompensated HF. . We enrolled 240 patients who met the study criteria. Forty-eight (20%) patients were readmitted for decompensated HF within thirty days of hospital discharge, and 192 (80%) patients were not readmitted. Compared to readmitted patients, nonreadmitted patients had a higher average KCCQ score (40.8 versus 32.6, = 0.019) before discharge. Multivariate analyses showed that a high KCCQ score was associated with low HF readmission rate (adjusted OR = 0.566, = 0.022). The -statistic for the base model (age + gender) was 0.617. The combination of home medication and lab tests on the base model resulted in an integrated discrimination improvement (IDI) increase of 3.9%. On that basis, the KCQQ further increased IDI of 2.7%. . The KCCQ score determined before hospital discharge was significantly associated with 30-day readmission rate in patients with HF, which may provide a clinically useful measure and could significantly improve readmission prediction reliability when combined with other clinical components.
心力衰竭(HF)是与住院再入院相关的最常见诊断之一。我们设计了这项前瞻性研究,以评估堪萨斯城心肌病问卷(KCCQ)评分是否与失代偿性HF住院患者的30天再入院相关。我们纳入了240名符合研究标准的患者。48名(20%)患者在出院后30天内因失代偿性HF再次入院,192名(80%)患者未再次入院。与再次入院的患者相比,未再次入院的患者出院前的KCCQ平均得分更高(40.8对32.6,P = 0.019)。多变量分析显示,KCCQ得分高与HF再入院率低相关(调整后的OR = 0.566,P = 0.022)。基础模型(年龄+性别)的C统计量为0.617。在基础模型上结合家庭用药和实验室检查,综合辨别改善(IDI)增加了3.9%。在此基础上,KCQQ进一步使IDI增加了2.7%。出院前确定的KCCQ评分与HF患者的30天再入院率显著相关,这可能提供一种临床上有用的测量方法,并且与其他临床因素结合时可显著提高再入院预测的可靠性。