Pu Boxuan, Wang Wei, Yu Yanwu, Peng Yue, Lei Lubi, Li Jingkuo, Zhang Lihua, Li Jing
National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, 100037 Beijing, China.
Rev Cardiovasc Med. 2024 Aug 8;25(8):279. doi: 10.31083/j.rcm2508279. eCollection 2024 Aug.
Patients with acute heart failure (HF) are at high risk of 30-day readmission. Little is known about the characteristics and associated factors of 30-day readmissions among patients with acute HF in China.
We enrolled consecutive patients hospitalized for acute HF and discharged from 52 hospitals in China from August 2016 to May 2018. We describe the rate of 30-day readmission, the time interval from discharge to readmission, and the causes of readmission. We also analyzed the factors associated with readmission risk by fitting multivariate Cox proportional hazards models.
We included 4875 patients with a median age of 67 years (interquartile range, 57-75), 3045 (62.5%) of whom were male. Within 30 days after discharge, 613 (12.6%) patients were readmitted for all causes, with a median from discharge to readmission of 12 (6-21) days. Most readmissions were attributed to cardiovascular causes (71.1%) and 60.0% to HF-related causes. Readmission occurred within 14 days of discharge in more than half of the patients (56.4%). Diabetes (hazard ratio [HR]: 1.25, 95% confidence interval [95% CI]: 1.06-1.50), anemia (HR: 1.26, 95% CI: 1.03-1.53), high New York Heart Association classification (HR: 1.48, 95% CI: 1.08-2.01), elevated N-terminal pro-B type natriuretic peptide (HR: 1.67, 95% CI: 1.24-2.25), and high-sensitivity cardiac troponin T (HR: 1.26, 95% CI: 1.01-1.58) were associated with increased risks of readmission. High systolic blood pressure (HR: 0.56, 95% CI: 0.38-0.81) and Kansas City Cardiomyopathy Questionnaire-12 scores (HR: 0.64, 95% CI: 0.44-0.94) were associated with decreased risk of readmission.
In China, almost one in eight patients with acute HF were readmitted within 30 days after discharge, mainly due to cardiovascular reasons, and approximately three-fifths of the readmissions occurred in the first 14 days. Both clinical and patient-centered characteristics were associated with readmission.
急性心力衰竭（HF）患者30天再入院风险较高。在中国，关于急性HF患者30天再入院的特征及相关因素知之甚少。
我们纳入了2016年8月至2018年5月期间在中国52家医院住院并出院的连续性急性HF患者。我们描述了30天再入院率、出院至再入院的时间间隔以及再入院原因。我们还通过拟合多变量Cox比例风险模型分析了与再入院风险相关的因素。
我们纳入了4875例患者，中位年龄为67岁（四分位间距，57 - 75岁），其中3045例（62.5%）为男性。出院后30天内，613例（12.6%）患者因各种原因再次入院，出院至再入院的中位时间为12（6 - 21）天。大多数再入院归因于心血管原因（71.1%），60.0%归因于HF相关原因。超过一半的患者（56.4%）在出院后14天内再次入院。糖尿病（风险比[HR]：1.25，95%置信区间[95%CI]：1.06 - 1.50）、贫血（HR：1.26，95%CI：1.03 - 1.53）、纽约心脏协会分级高（HR：1.48，95%CI：1.08 - 2.01）、N末端B型利钠肽原升高（HR：1.67，95%CI：1.24 - 2.25）以及高敏肌钙蛋白T升高（HR：1.26，95%CI：1.01 - 1.58）与再入院风险增加相关。高收缩压（HR：0.56，95%CI：0.38 - 0.81）和堪萨斯城心肌病问卷 - 12得分（HR：0.64，95%CI：0.44 - 0.94）与再入院风险降低相关。
在中国，近八分之一的急性HF患者在出院后30天内再次入院，主要是由于心血管原因，约五分之三的再入院发生在出院后的前14天。临床特征和以患者为中心的特征均与再入院相关。
