Comorbidities key factor in HF readmissions
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Among patients with HF discharged from a hospital in Sweden, 20.3% were readmitted to the hospital within 30 days, and 60.9% were readmitted within 1 year, researchers reported.
The number of comorbidities was associated with readmission, according to the researchers.
“In this real-world cohort of HF patients, hospital readmissions frequently occurred early during the post-discharge period, mainly driven by worsening HF. Moreover, risk factors varied among hospital readmissions of different causes and at different time periods,” Maria Wideqvist, MS, from the department of molecular and clinical medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sweden, and colleagues wrote.
The study population consisted of 448 patients (mean age, 78 years; 45% women).
The 1-year all-cause readmission rate was 60.9%, the 1-year HF-related readmission rate was 38.4% and the 3-month all-cause readmission rate was 36.6%, Wideqvist and colleagues wrote.
Most patients in the cohort had three to ve comorbidities, and the risk for readmission rose with increasing number of comorbidities (P for trend for 1-month all-cause readmissions = .006; P for trend for 1-year all-cause readmissions < .001; P for trend for 1-year HF readmissions = .012), the researchers wrote.
Worsening HF contributed to 63% of all readmissions, whereas the following comorbidities were more common in those who were readmitted than in those who were not: renal dysfunction (52.4% vs. 36.6%; P = .001), pulmonary disease (25.6% vs. 15.4%; P = .01) and psychiatric illness (24.9% vs. 12%, P = .001), according to the researchers.
Poor compliance to medication was an independent risk factor for HF readmission (HR = 3.62; 95% CI, 1.17-11.14).
“Adherence to HF treatment is crucial because specic medication reduce both mortality and morbidity. Targeting specic individuals at risk for readmission with a disease management program can improve compliance to medication and hereby lessen the burden of mortality as well as morbidity,” the researchers wrote.
Wideqvist and colleagues wrote that post-discharge management and timely optimization of HF care are crucial for preventing hospital readmission. In addition, comorbidities are associated with frequent hospital readmission, which underscores the importance of involving other specialties when managing HF patients.
“By targeting high-risk HF population for hospital readmission and directing appropriate interventions towards these patients, many hospital readmissions should be preventable,” the researchers wrote.
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