PhD Programme in Economics (DEcIDE), International Doctorate School of the National University of Distance Education (EIDUNED), 28015, Madrid, Spain.
Research Unit of Don Benito-Villanueva de la Serena Health Area, 06700, Villanueva de la Serena, Spain.
Sci Rep. 2023 Dec 18;13(1):22477. doi: 10.1038/s41598-023-49390-w.
To determine the readmissions trends and the comorbidities of patients with heart failure that most influence hospital readmission rates. Heart failure (HF) is one of the most prevalent health problems as it causes loss of quality of life and increased health-care costs. Its prevalence increases with age and is a major cause of re-hospitalisation within 30 days after discharge. INCA study had observational and ambispective design, including 4,959 patients from 2000 to 2019, with main diagnosis of HF in Extremadura (Spain). The variables examined were collected from discharge reports. To develop the readmission index, capable of discriminating the population with higher probability of re-hospitalisation, a Competing-risk model was generated. Readmission rate have increased over the period under investigation. The main predictors of readmission were: age, diabetes mellitus, presence of neoplasia, HF without previous hospitalisation, atrial fibrillation, anaemia, previous myocardial infarction, obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). These variables were assigned values with balanced weights, our INCA index showed that the population with values greater than 2 for men and women were more likely to be re-admitted. Previous HF without hospital admission, CKD, and COPD appear to have the greatest effect on readmission. Our index allowed us to identify patients with different risks of readmission.
为了确定心力衰竭患者再入院的趋势和影响住院再入院率的主要合并症。心力衰竭（HF）是最常见的健康问题之一，因为它会导致生活质量下降和医疗保健费用增加。其患病率随年龄增长而增加，是出院后 30 天内再次住院的主要原因。INCA 研究采用观察性和前瞻性设计，纳入了 2000 年至 2019 年来自西班牙埃斯特雷马杜拉的 4959 名主要诊断为心力衰竭的患者。检查的变量从出院报告中收集。为了开发能够区分再入院概率较高人群的再入院指数，生成了竞争风险模型。在此期间，再入院率有所增加。再入院的主要预测因素是：年龄、糖尿病、肿瘤存在、无既往住院史的心力衰竭、心房颤动、贫血、既往心肌梗死、阻塞性肺疾病（COPD）和慢性肾脏病（CKD）。这些变量被赋予平衡权重的值，我们的 INCA 指数表明，男性和女性值大于 2 的人群更有可能再次入院。既往无住院史的心力衰竭、CKD 和 COPD 似乎对再入院的影响最大。我们的指数能够识别具有不同再入院风险的患者。
