Department of Adult Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia.
Department of Adult Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Sci Rep. 2024 Oct 8;14(1):23473. doi: 10.1038/s41598-024-71257-x.
The burden of heart failure increases over time and is a leading cause of unplanned readmissions worldwide. In addition, its impact has doubled in countries with limited health resources, including Ethiopia. Identifying and preventing the possible contributing factors is crucial to reducing unplanned hospital readmissions and improving clinical outcomes. The study aimed to assess the incidence and predictors of 30-day unplanned readmission among heart failure patients at selected South Wollo general hospitals in 2022. A hospital-based retrospective cohort study design was employed from January 1, 2016, to December 30, 2020. The data was collected from 572 randomly selected medical records using data extraction checklists. Data were entered in Epi-Data version 4.6 and analyzed with Stata version 17. The Kaplan-Meier and log-rank tests were used to estimate and compare the survival failure time. A Cox proportional hazard analysis was used to identify the predictors of readmission. The statistical significance level was declared at a p-value < 0.05 with an adjusted odds ratio and a 95% confidence interval. A total of 151 (26.40%) heart failure patients were readmitted within 30 days of discharge. Among the study participants, 302 (52.8%) were male, and 370 (64.7%) were rural residents. The mean age was 45.8 ± 14.1 SD years. In the multivariate Cox proportional hazards analysis being an age (> 65 years) (AHR: 3.172, 95% CI:.21, 4.55, P = 0.001), rural in residency (AHR: 2.47, 95%CI: 1.44, 4.24, P = 0.001), Asthma or Chronic Obstructive Pulmonary Disease (AHR: 1.62, 95% CI: 1.11, 2.35, P = 0.012), HIV/AIDS (AHR: 1.84, 95%CI: 1.24, 2.75, P = 0.003), Haemoglobin level 8-10.9 g/dL (AHR: 6.20, 95% CI: 3.74, 10.28, P = 0.001), and Mean platelet volume > 9.1 fl (AHR: 2.08, 95% CI: 1.27, 3.40, P = 0.004) were identified as independent predictors of unplanned hospital readmission. The incidence of unplanned hospital readmission was relatively high among heart failure patients. Elderly patients, rural residency, comorbidity, a higher mean platelet volume, and a low hemoglobin level were independent predictors of readmission. Working on these factors will help reduce the hazards of unplanned hospital readmission.
心力衰竭的负担随着时间的推移而增加，是全球计划外再入院的主要原因。此外，在卫生资源有限的国家，包括埃塞俄比亚，其影响增加了一倍。确定和预防可能的促成因素对于减少计划外医院再入院和改善临床结果至关重要。本研究旨在评估 2022 年在选定的南沃洛综合医院的心力衰竭患者 30 天内计划外再入院的发生率和预测因素。采用 2016 年 1 月 1 日至 2020 年 12 月 30 日的基于医院的回顾性队列研究设计。从 572 名随机选择的病历中使用数据提取检查表收集数据。数据输入 Epi-Data 版本 4.6 并使用 Stata 版本 17 进行分析。使用 Kaplan-Meier 和对数秩检验估计和比较生存失败时间。使用 Cox 比例风险分析确定再入院的预测因素。统计显著性水平定义为 p 值 < 0.05，调整后的优势比和 95%置信区间。共有 151 名（26.40%）心力衰竭患者在出院后 30 天内再次入院。在研究参与者中，302 名（52.8%）为男性，370 名（64.7%）为农村居民。平均年龄为 45.8 ± 14.1 岁。在多变量 Cox 比例风险分析中，年龄（> 65 岁）（AHR：3.172，95%CI：.21，4.55，P = 0.001）、农村居住（AHR：2.47，95%CI：1.44，4.24，P = 0.001）、哮喘或慢性阻塞性肺疾病（AHR：1.62，95%CI：1.11，2.35，P = 0.012）、艾滋病毒/艾滋病（AHR：1.84，95%CI：1.24，2.75，P = 0.003）、血红蛋白水平 8-10.9 g/dL（AHR：6.20，95%CI：3.74，10.28，P = 0.001）和平均血小板体积> 9.1 fl（AHR：2.08，95%CI：1.27，3.40，P = 0.004）被确定为计划外医院再入院的独立预测因素。心力衰竭患者计划外医院再入院的发生率相对较高。老年患者、农村居住、合并症、较高的平均血小板体积和较低的血红蛋白水平是再入院的独立预测因素。针对这些因素将有助于降低计划外医院再入院的风险。
