Liang Mengyao, Yang Qingqing, Lu Yi, Wang Yanmei
Department of Nursing, The Sixth People's Hospital of Nantong, Jiangsu, China.
Department of Cardiology, The Sixth People's Hospital of Nantong, Jiangsu, China.
Medicine (Baltimore). 2025 Feb 14;104(7):e41567. doi: 10.1097/MD.0000000000041567.
This study aimed to identify the factors influencing multiple admissions within 1 year for patients with heart failure (HF) and to examine the impact of early readmission on subsequent admissions. A retrospective questionnaire survey was conducted on 498 patients with HF admitted to our hospital's Cardiology department between January 1, 2020, and December 31, 2022. Multivariate regression analysis identified factors influencing multiple admissions, and propensity score matching (PSM) assessed the impact of readmissions within 30 days and 31 to 90 days post-discharge on unplanned admissions within a year. The incidence of multiple admissions was 22.09% (110/498), with first readmissions within 30 days post-discharge at 13.25% (66/498) and within 31 to 90 days at 15.86% (79/498). Influential factors for multiple unplanned hospital admissions included age, history of atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, New York Heart Association grade ≥ III, hemoglobin (Hb) < 110g/L, taking 7 or more medications, and readmission within 31 to 90 days (P < .05). Post-PSM analysis showed that the first admission within 30 days (odds ratio [OR] = 6.400, 95% confidence interval [Cl] = 2.638-15.527, P = .001), and the first admission within 31 to 90 days significantly increased the risk of multiple admissions (OR = 5.694, 95% Cl = 2.615-12.402, P = .001). Patients with HF exhibit a high rate of numerous readmissions within 1 year. Clinical medical staff should focus more on patients with early readmissions, enhance self-management, and improve management of comorbidities and medications through a multidisciplinary team approach. Enhancing continuous nursing and improving access to medical services may reduce patient readmission rates.
本研究旨在确定影响心力衰竭(HF)患者1年内多次入院的因素,并探讨早期再入院对后续入院的影响。对2020年1月1日至2022年12月31日期间我院心内科收治的498例HF患者进行了回顾性问卷调查。多因素回归分析确定了影响多次入院的因素,倾向得分匹配(PSM)评估了出院后30天内和31至90天内再入院对1年内非计划入院的影响。多次入院发生率为22.09%(110/498),出院后30天内首次再入院率为13.25%(66/498),31至90天内为15.86%(79/498)。非计划多次住院的影响因素包括年龄、心房颤动病史、慢性肾脏病、慢性阻塞性肺疾病、纽约心脏协会分级≥Ⅲ级、血红蛋白(Hb)<110g/L、服用7种或更多药物以及31至90天内再入院(P<0.05)。PSM分析后显示,30天内首次入院(比值比[OR]=6.400,95%置信区间[Cl]=2.638-15.527,P=0.001)以及31至90天内首次入院显著增加了多次入院风险(OR=5.694,95%Cl=2.615-12.402,P=‘001)。HF患者1年内再入院率较高。临床医务人员应更多关注早期再入院患者,加强自我管理,并通过多学科团队方法改善合并症和药物治疗管理。加强持续护理并改善医疗服务可降低患者再入院率。