充血性心力衰竭患者30天再入院的危险因素。
Risk factors for 30-day readmission in patients with congestive heart failure.
作者信息
Mirkin Katelin A, Enomoto Laura M, Caputo Gregory M, Hollenbeak Christopher S
机构信息
Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Department of Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
出版信息
Heart Lung. 2017 Sep-Oct;46(5):357-362. doi: 10.1016/j.hrtlng.2017.06.005. Epub 2017 Aug 8.
BACKGROUND
Risk of readmission is elevated in patients congestive heart failure (CHF), and clinical decision makers need to better understand risk factors for 30-day readmissions.
OBJECTIVE
To identify risk factors for readmission in patients with CHF.
METHODS
We studied all admissions for patients with CHF during 2011 using a statewide discharge data set from Pennsylvania. The primary outcome was readmission to any Pennsylvania hospital within 30 days of discharge.
RESULTS
Of 155,146 CHF patients admitted, 35,294 (22.8%) were readmitted within 30 days. Male sex, black race, coverage by Medicare, comorbidities, discharge to a skilled nursing facility or with a home nurse, a longer length of stay (LOS), admission from another facility, and emergent admission (all p < 0.001) were significant risk factors.
CONCLUSIONS
Comorbidities, sociodemographic factors including male sex, age, black race and Medicare coverage, and prolonged length of stay are associated with increased risk of readmission in patients with CHF.
背景
充血性心力衰竭（CHF）患者再次入院风险升高，临床决策者需要更好地了解30天再入院的风险因素。
目的
确定CHF患者再入院的风险因素。
方法
我们利用宾夕法尼亚州的全州出院数据集研究了2011年期间CHF患者的所有入院情况。主要结局是出院后30天内再次入住宾夕法尼亚州的任何医院。
结果
在155146例入院的CHF患者中，35294例（22.8%）在30天内再次入院。男性、黑人种族、医疗保险覆盖、合并症、出院至专业护理机构或有家庭护士、住院时间较长、从其他机构入院以及急诊入院（所有p<0.001）均为显著的风险因素。
结论
合并症、社会人口学因素（包括男性、年龄、黑人种族和医疗保险覆盖）以及住院时间延长与CHF患者再入院风险增加相关。
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