Gedfew Mihretie, Tesfaye Bekele, Amha Haile, Wondie Tirusew, Gedif Getnet, Gietaneh Wodajie, Akalu Tadesse Yirga, Yismaw Lieltework, Diress Gedefaw
College of Health Science Debre Markos University Debre Markos Ethiopia.
Health Sci Rep. 2025 Jan 31;8(2):e70408. doi: 10.1002/hsr2.70408. eCollection 2025 Feb.
Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia.
This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023.
A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity.
Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; < 0.004) was linked with a higher likelihood of remaining in the "always-zero" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; < 0.036). The mortality rate among readmitted patients was 11.39%.
This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.
心力衰竭是埃塞俄比亚西北部阿姆哈拉地区医院再入院的主要原因。
本研究旨在确定2023年埃塞俄比亚西北部阿姆哈拉地区转诊医院心力衰竭患者的再入院人数，并确定其决定因素。
2022年9月至2023年2月，对阿姆哈拉地区转诊医院的663名心力衰竭患者进行了一项横断面研究。采用简单随机抽样方法选择患者，通过病历审查和访谈式问卷收集数据。应用零膨胀负二项式模型进行数据分析。数据收集工具进行了预测试，以确保信度和效度。
在663名患者中，237名（35.7%）至少有一次再入院。呼吸频率增加（发生率比[IRR]=1.015；95%置信区间[CI]：1.0004，1.031；P<0.044）和用药时间延长（IRR=1.011；95%CI：1.016，1.051；P<0.0001）与更多的再入院相关。社会支持差的患者再入院次数比社会支持好的患者少59.4%（IRR=-1.595；95%CI：-0.02，-0.005；P<0.041）。较高的体重指数（IRR=0.115；95%CI：0.035，0.196；P<0.004）与留在“始终为零”组的可能性较高相关，而脉搏率增加则降低了这种可能性（IRR=-0.013；95%CI：-0.025，-0.008；P<0.036）。再入院患者的死亡率为11.39%。
本研究发现心力衰竭患者的再入院率较高。呼吸频率和用药时间等因素与再入院增加有关，而社会支持差与再入院减少有关，这可能反映了中低收入国家社会支持较低的个体获得医疗服务的机会有限。高死亡率突出了需要有针对性的干预措施来改善患者的治疗结果。
