Medical and socioenvironmental predictors of hospital readmission in patients with congestive heart failure.

M. Tsuchihashi, H. Tsutsui, K. Kodama, F. Kasagi, S. Setoguchi, M. Mohr, T. Kubota, A. Takeshita

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Abstract

BACKGROUND: Patients with chronic congestive heart failure (CHF) require frequent rehospitalization because of the exacerbation of CHF. It is of clinical importance to determine predicting factors for readmission to reduce this likelihood. Previous studies have focused primarily on the demographic and medical characteristics in selected subsets of patients. Therefore, within a broad cohort of consecutively hospitalized patients, we sought to identify not only demographic and medical predictors but also socioenvironmental factors associated with readmission. METHODS: We assessed demographic (age, sex), medical (etiology of CHF, New York Heart Association functional class, left ventricular ejection fraction, previous admission for CHF, length of hospital stay, comorbidity, and medications), and socioenvironmental variables (occupation, financial resources, living alone, and follow-up visits) in 230 patients discharged with a diagnosis of CHF and recorded hospital readmission. RESULTS: Within 1 year after discharge, 81 patients (35%) were readmitted. Five variables, including poor follow-up visits (odds ratio [OR] 4.9, 95% CI 2.0-11.8), previous admission for CHF (OR 3.3, 95% CI 1.8-6.1), no occupation (OR 2.6, 95% CI 1.2-5.5), longer hospital stay (OR 3.2, 95% CI 1.2-8.5), and hypertension (OR 2.0, 95% CI 1.1-3.7), were identified as significant independent predictors for readmission by multivariate logistic regression analysis. CONCLUSIONS: Our independent predictors of readmission support the importance of medical and socioenvironmental factors in the deterioration of CHF. Therefore interventions to decrease readmission should also target social management in all hospitalized patients.

Original languageEnglish
Pages (from-to)E7
JournalAmerican heart journal
Volume142
Issue number4
Publication statusPublished - Oct 2001

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Tsuchihashi, M., Tsutsui, H., Kodama, K., Kasagi, F., Setoguchi, S., Mohr, M., Kubota, T., & Takeshita, A. (2001). Medical and socioenvironmental predictors of hospital readmission in patients with congestive heart failure. American heart journal, 142(4), E7.