Cui Lingling, Wei Xiaolei, Liang Tao, Yan Rui, Du Minyu, Alimire Tusiyiti, Huang Yuyang, Wang Hua
Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng District, Beijing, China.
School of nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC Cardiovasc Disord. 2025 Apr 8;25(1):269. doi: 10.1186/s12872-025-04674-z.
Heart failure imposes a significant healthcare burden, with early unplanned readmissions post-discharge linked to poor outcomes. Identifying risk factors and their predictive value is crucial for targeted interventions.
To investigate gender differences in cumulative hazard function and the factors influencing 30-day unplanned readmissions in heart failure patients, and to compare their predictive value.
A prospective study of heart failure patients hospitalized in Beijing Hospital from October 2023 to March 2024. Patients' nutritional status was assessed using the Mini-Nutritional Assessment Scale Short Version (MNA-SF), frailty was evaluated using the Groningen Frailty Index (GFI), and the Appendicular Skeletal Muscle Mass Index (ASMI) was calculated. Multifactorial Cox regression analysis was conducted, and ROC curves were plotted for predictive modeling.
A total of 121 heart failure patients (60.3% males), aged (69.87 ± 11.9) years were included. With a median follow-up duration of 30 days, 25 (20.7%) patients with readmission. COX regression analysis stratified by gender showed that age, regular smoking, nutritional status, left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP), GFI, and ASMI were independent predictors of readmission within 30 days in patients with heart failure (P < 0.050). ROC curve analysis showed that age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI individually as well as in combination predicted readmission within 30 days in patients with heart failure; the joint model performed optimally, with an AUC value reaching 0.877 (95%CI 0.801 ∼ 0.952, P < 0.001), with a sensitivity of 0.920 and a specificity of 0.729.
A multifactorial approach including age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI predicts 30-day readmission risk, offering a basis for clinical intervention strategies to improve patient outcomes.
心力衰竭给医疗保健带来了沉重负担，出院后早期非计划再入院与不良预后相关。识别风险因素及其预测价值对于有针对性的干预措施至关重要。
探讨心力衰竭患者累积风险函数的性别差异以及影响30天非计划再入院的因素，并比较它们的预测价值。
对2023年10月至2024年3月在北京医院住院的心力衰竭患者进行前瞻性研究。使用微型营养评定量表简表（MNA-SF）评估患者的营养状况，使用格罗宁根衰弱指数（GFI）评估衰弱情况，并计算四肢骨骼肌质量指数（ASMI）。进行多因素Cox回归分析，并绘制ROC曲线进行预测建模。
共纳入121例心力衰竭患者（男性占60.3%），年龄为（69.87±11.9）岁。中位随访时间为30天，25例（20.7%）患者再入院。按性别分层的COX回归分析显示，年龄、经常吸烟、营养状况、左心室射血分数（LVEF）、脑钠肽（BNP）、GFI和ASMI是心力衰竭患者30天内再入院的独立预测因素（P<0.050）。ROC曲线分析表明，年龄、BNP、ASMI、吸烟状态、LVEF、营养状况和GFI单独以及联合起来都能预测心力衰竭患者30天内的再入院情况；联合模型表现最佳，AUC值达到0.877（95%CI 0.801～0.952，P<0.001），敏感性为0.920，特异性为0.729。
包括年龄、BNP、ASMI、吸烟状态、LVEF、营养状况和GFI在内的多因素方法可预测30天再入院风险，为改善患者预后的临床干预策略提供了依据。
