Ayatollahi Yousef, Liu Xibei, Namazi Ali, Jaradat Mohammad, Yamashita Takashi, Shen Jay J, Lee Yong-Jae, Upadhyay Soumya, Kim Sun Jung, Yoo Ji Won
Res Gerontol Nurs. 2018 Jul 1;11(4):190-197. doi: 10.3928/19404921-20180322-01. Epub 2018 Apr 11.
The current study evaluated risk factors of early hospital readmission in geriatric patients with acute heart failure (HF) and analyzed 2,279 consecutively hospitalized older adults with decompensated HF from November 2013 to October 2014 across 15 U.S. hospitals. The eTracker-HF was designed to make risk factors known to treating clinicians in electronic health records. Multilevel multivariate logistic regression was applied to examine the association between risk factors and all-cause and HF 30-day readmission rates. All-cause and HF 30-day readmission rates were 22.3% and 9.8%, respectively. Old age, non-White ethnicity, delirium, physical impairment, ejection fraction <40%, advanced chronic kidney disease, and previous myocardial infarction were associated with all-cause and HF readmission. Home health care use was inversely associated with early readmission. In addition to demographic and cardiovascular risk factors, geriatric syndromes were associated with early readmission. Discharge to home health care may reduce early readmission in these patients. [Res Gerontol Nurs. 2018; 11(4):190-197.].
本研究评估了老年急性心力衰竭(HF)患者早期再入院的风险因素,并分析了2013年11月至2014年10月期间美国15家医院连续收治的2279例失代偿性HF老年患者。eTracker-HF旨在使治疗临床医生能够在电子健康记录中了解风险因素。应用多水平多变量逻辑回归分析风险因素与全因及HF 30天再入院率之间的关联。全因和HF 30天再入院率分别为22.3%和9.8%。高龄、非白人种族、谵妄、身体功能障碍、射血分数<40%、晚期慢性肾病和既往心肌梗死与全因和HF再入院相关。使用家庭医疗保健与早期再入院呈负相关。除人口统计学和心血管风险因素外,老年综合征也与早期再入院相关。出院后接受家庭医疗保健可能会降低这些患者的早期再入院率。[《老年护理研究》。2018年;11(4):190 - 197。]