Early Readmission Risk Identification for Hospitalized Older Adults With Decompensated Heart Failure

Ayatollahi, Yousef; Liu, Xibei; Namazi, Ali; Jaradat, Mohammad A.; Yamashita, Takashi; Shen, Jay J.; Lee, Yong Jae; Upadhyay, Soumya; Kim, Sun Jung; Yoo, Ji Won

doi:10.3928/19404921-20180322-01

Cited by 13 publications

(16 citation statements)

References 27 publications

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“…More than 1 patient over 4 were readmitted to the hospital in our study population after 30 days. Our readmission rate was more frequent than those observed in some previous studies (37)(38)(39) over the same follow-up time, yet the discrepancies could be explained by the age of the patients (much older in our population than in the others (37)(38)(39), high comorbidity burden (which was evaluated in our study, whether not entirely specified in other ones), and in line with Molvin et al who observed a 33.5% readmission rate, in a Swedish cohort of 268 patients (mean age 75 years) over a follow-up time of 5 months (40).…”

Section: Discussioncontrasting

confidence: 60%

Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients

Fantin

Giani

Franconi

et al. 2022

Front. Cardiovasc. Med.

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Arterial stiffness and subendocardial perfusion impairment may play a significant role in heart failure (HF) outcomes. The aim of the study was to examine the main predictors of 30-day readmission in geriatric patients, hospitalized with HF, explore hemodynamical parameters, arterial stiffness indexes, and subendocardial viability ratio (SEVR). In total, 41 hospitalized patients, affected by HF, were included; they underwent clinical evaluation, routine laboratory testing, and echocardiography. At the time of admission, after the achievement of clinical stability (defined as switching from intravenous to oral diuretic therapy), and at discharge, arterial tonometry was performed to evaluate carotid-femoral pulse wave velocity (PWVcf) and SEVR (then corrected for hemoglobin concentration and oxygen saturation). Through the evaluations, a significant progressive decrease in PWVcf was described (17.79 ± 4.49, 13.54 ± 4.54, and 9.94 ± 3.73 m/s), even after adjustment for age, gender, mean arterial pressure (MAP) variation, and left ventricular ejection fraction (LVEF). A significant improvement was registered for both SEVR (83.48 ± 24.43, 97.94 ± 26.84, and 113.29 ± 38.02) and corrected SEVR (12.74 ± 4.69, 15.71 ± 5.30, and 18.55 ± 6.66) values, and it was still significant when adjusted for age, gender, MAP variation, and LVEF. After discharge, 26.8% of patients were readmitted within 30 days. In a multivariate binary logistic regression analysis, PWVcf at discharge was the only predictor of 30-day readmission (odds ratio [OR] 1.957, 95% CI 1.112–3.443). In conclusion, medical therapy seems to improve arterial stiffness and subendocardial perfusion in geriatric patients hospitalized with heart failure. Furthermore, PWVcf is a valid predictor of 30-day readmission. Its feasibility in clinical practice may provide an instrument to detect patients with HF at high risk of rehospitalization.

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Section: Discussioncontrasting

confidence: 60%

Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients

Fantin

Giani

Franconi

et al. 2022

Front. Cardiovasc. Med.

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“…The readmission rate in our study for Chinese senile patients with acute decompensated heart failure was 33.55%, much higher than that as reported by other researchers which ranges from16.8% [6]to 32.6% [7]. Since heart failure has an overwhelming prevalence among senile groups, meanwhile old age is also a risk factor for readmission.…”

Section: Discussioncontrasting

confidence: 58%

Readmission Reasons of Senile Patients Hospitalized with Acute Decompensated Heart Failure in Different Department: A Retrospective Study

Zhao¹,

Jin²,

Sheng³

et al. 2019

Preprint

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Background -The readmission reasons for senile patients hospitalized in different wards with acute decompensated heart failure are not well known. Method -We conducted a retrospective study of senile patients admitted to the People’s Hospital of Sichuan Province in a one-year period. Patients suffered with heart failure were identified from the hospital administrative database. Chart reviews were carried out to explore 30-day readmission reasons. Descriptive statistics were utilized to compare the patients and hospital characteristics among different wards. Student’s t-test was used for normally distributed continuous variables, chi-square for categorical variables. Results -Of all the hospitalization cases (3922), 1316 patients with heart failure were rehospitalized, among which 893 were admitted to geriatric department. The readmission rate was 33.55%. The top 10 reasons for rehospitalization in geriatric department were AECOPD (18.5%), hypertension (15.5%), hypertensive heart disease (13.3%),pneumonia (10.5%), coronary artery disease(7.0%), acute coronary syndrome(11.3%), dementia (6.8%), PAD (3.25%), stroke (2.2%), cancer/valvular heart disease (1.4%).The top 10 reasons in other departments were stroke (32.5%), AECOPD (10.7%), pneumonia (10.0%), coronary artery disease(6.8%),CKD (5.9%), cancer(5.7%), hypertensive heart disease (4.8%), dementia (4.6%), valvular heart disease (3.3%), DCM (2.6%). Geriatric department tended to receive more senile patients than other wards, and had longer days of hospitalization(24.38±5.228 vs15.65±5.907), however, the cost among different wards was of no difference (31345.53±1343.354 vs 30868.49±2241.292). In terms of discharge disposition, 98.95% patients in geriatric department were discharged straight to home, ‘which was statistically higher than that of other wards (86.68%). Conclusion -This study shows the prevailing reasons for readmission of senile patients hospitalized with acute decompensated heart failure. Long term or short term care is summoned in China.

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“…The unscheduled readmission rate was defined as the rate of the emergency visit and the unscheduled rehospitalization within 12 weeks of intervention to evaluate the chronic disease progression (Ayatollahi et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of a mutual goal‐based continuous care program on self‐management behaviour and health outcomes in patients after percutaneous coronary intervention: A randomized controlled trial

2023

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Aims To evaluate the effects of mutual goal‐based continuous care program on the outcomes of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Design A single‐blinded randomized controlled trial. Methods 87 patients with CHD after PCI in Hangzhou, Zhejiang, China, were randomly divided into study ( n = 42) and control ( n = 45) groups. The control group received 12‐week cardiac rehabilitation and routine care. The study group received routine care and cardiac rehabilitation and the 12‐week intervention program developed according to the goal attainment theory, including the mutual goal‐based face‐to‐face guidance, and every‐2‐week telephone follow‐ups. The self‐management behaviour, quality of life, unscheduled readmission rate, and satisfaction of patients were examined. Results For the patients subjected to the developed continuous nursing program based on mutual goals, achievement rates of all dimension mutual goals were at high levels (from 80.21% to 98.41%), except for the weight control (60.94%). Moreover, according to the comparable base data, compared with the control group, the self‐management behaviour (study group 93.43 vs. control group 76.00), quality of life (QoL), and patients' satisfaction (study group 4.64 vs. control group 4.11) were higher, while the unscheduled readmission rate (study group 4.76% vs. control group 22.22%) was lower, in the study group, with statistically significant differences.

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Early Readmission Risk Identification for Hospitalized Older Adults With Decompensated Heart Failure

Cited by 13 publications

References 27 publications

Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients

Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients

Readmission Reasons of Senile Patients Hospitalized with Acute Decompensated Heart Failure in Different Department: A Retrospective Study

Effect of a mutual goal‐based continuous care program on self‐management behaviour and health outcomes in patients after percutaneous coronary intervention: A randomized controlled trial

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