Baris Remzi Oguz, Tabit Corey E
Section of Cardiology, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.
J Clin Med. 2025 Aug 21;14(16):5894. doi: 10.3390/jcm14165894.
Heart failure readmissions remain a major challenge for healthcare systems, contributing significantly to morbidity, mortality, and increased healthcare costs. Despite advancements in medical and device-based therapies, rehospitalization rates remain high, particularly within the first 30 days of discharge. This review aims to evaluate the primary factors associated with HF readmissions and discuss evidence-based strategies to reduce these rates. The review examines the efficacy of pharmacological therapies and their impact on readmission rates, highlighting key interventions such as diuretics, beta-blockers, ACE inhibitors, ARBs, ARNIs, SGLT2 inhibitors, and intravenous iron supplementation. Additionally, device-based interventions, including CardioMEMS, LVADs, CRT-P/D, ICDs, Furoscix, and the ReDS vest, are critically evaluated for their role in the early detection and management of decompensation. Non-pharmacological strategies are also underscored, such as dietary modifications, exercise, cardiac rehabilitation, and structured follow-up programs. By synthesizing current evidence, this review provides a comprehensive analysis of heart failure readmission factors and proposes multidisciplinary, patient-centered strategies to improve outcomes and reduce hospitalizations.
心力衰竭再入院仍然是医疗系统面临的一项重大挑战，对发病率、死亡率以及医疗成本的增加有显著影响。尽管在药物治疗和基于设备的治疗方面取得了进展，但再住院率仍然很高，尤其是在出院后的头30天内。本综述旨在评估与心力衰竭再入院相关的主要因素，并讨论基于证据的降低这些比率的策略。该综述考察了药物治疗的疗效及其对再入院率的影响，重点介绍了利尿剂、β受体阻滞剂、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、血管紧张素受体脑啡肽酶抑制剂、钠-葡萄糖协同转运蛋白2抑制剂和静脉补铁等关键干预措施。此外，还对基于设备的干预措施进行了严格评估，包括心脏监测系统、左心室辅助装置、心脏再同步化治疗起搏器/除颤器、植入式心脏复律除颤器、Furoscix和ReDS背心在失代偿早期检测和管理中的作用。非药物策略也得到了强调，如饮食调整、运动、心脏康复和结构化随访计划。通过综合现有证据，本综述对心力衰竭再入院因素进行了全面分析，并提出了多学科、以患者为中心的策略，以改善治疗结果并减少住院次数。
