Precipitating factors and clinical impact of early rehospitalization for heart failure in patients with heart failure in Awaji Island, Japan
| العنوان: | Precipitating factors and clinical impact of early rehospitalization for heart failure in patients with heart failure in Awaji Island, Japan |
|---|---|
| المؤلفون: | Ryuji Toh, Junichi Imanishi, Takumi Inoue, Masamichi Iwasaki, Wataru Fujimoto, Koji Kuroda, Soichiro Yamashita, Tomoyo Hamana, Yutaka Hatani, Akihide Konishi, Takatoshi Hayashi, Ken-ichi Hirata, Hiroshi Okamoto, Masakazu Shinohara, Masanori Okuda |
| المصدر: | Journal of Cardiology. 77:645-651 |
| بيانات النشر: | Elsevier BV, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Poor prognosis, 030204 cardiovascular system & hematology, Patient Readmission, Cardiovascular death, 03 medical and health sciences, 0302 clinical medicine, Japan, Risk Factors, Internal medicine, medicine, Humans, In patient, 030212 general & internal medicine, Aged, 80 and over, Heart Failure, Hospital readmission, business.industry, Mortality rate, Mean age, Precipitating Factors, medicine.disease, Heart failure, Cardiology, Female, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Recent reports have revealed that patients who experienced early rehospitalization for heart failure (HF) had worse prognoses in terms of all-cause and cardiovascular deaths as compared to those who did not. However, precipitating factors for early rehospitalization for HF remain unknown. In this study, we assessed the precipitating factors for early rehospitalization and their impact in patients with HF.We consecutively included 242 patients (mean age: 80.4 years, females: 46.3%) with a history of rehospitalization for HF. They were divided into 2 groups: the early rehospitalization group (71 patients who were readmitted within 3 months of discharge) and the late rehospitalization group (171 patients who were readmitted after more than 3 months following discharge). During the mean follow-up period of 1,144 days (range: 857-1,417 days), 121 patients (50.0%) died. Kaplan-Meier analysis revealed that patients in the early rehospitalization group had worse prognosis (all-cause death and cardiovascular death) than those in the late rehospitalization group (log-rank p0.001). As the major precipitating factor for rehospitalization, poor compliance with the doctor's instructions on fluid and physical activity restrictions (determined by the patients or their families admittance of non-compliance with the instructions given at the time of discharge) was higher in the early rehospitalization group than in the late rehospitalization group [poor compliance with fluid restriction: 19.7% vs. 7.6% (p = 0.006), poor compliance with physical activity restriction: 21.1% vs. 9.4% (p = 0.013)].We concluded that early hospital readmission in patients with HF was associated with higher mortality rates. Compared to late rehospitalization, precipitating factors for early rehospitalization were more strongly dependent on the self-care behaviors of the patients. A more effective approach, such as multidisciplinary intervention, is essential to prevent early hospital readmission and subsequent poor prognosis. |
| تدمد: | 0914-5087 |
| DOI: | 10.1016/j.jjcc.2020.12.014 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::880dac389f02618dbfdf1b6f229490c7 https://doi.org/10.1016/j.jjcc.2020.12.014 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....880dac389f02618dbfdf1b6f229490c7 |
| قاعدة البيانات: | OpenAIRE |
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However, precipitating factors for early rehospitalization for HF remain unknown. In this study, we assessed the precipitating factors for early rehospitalization and their impact in patients with HF.We consecutively included 242 patients (mean age: 80.4 years, females: 46.3%) with a history of rehospitalization for HF. They were divided into 2 groups: the early rehospitalization group (71 patients who were readmitted within 3 months of discharge) and the late rehospitalization group (171 patients who were readmitted after more than 3 months following discharge). During the mean follow-up period of 1,144 days (range: 857-1,417 days), 121 patients (50.0%) died. Kaplan-Meier analysis revealed that patients in the early rehospitalization group had worse prognosis (all-cause death and cardiovascular death) than those in the late rehospitalization group (log-rank p0.001). As the major precipitating factor for rehospitalization, poor compliance with the doctor's instructions on fluid and physical activity restrictions (determined by the patients or their families admittance of non-compliance with the instructions given at the time of discharge) was higher in the early rehospitalization group than in the late rehospitalization group [poor compliance with fluid restriction: 19.7% vs. 7.6% (p = 0.006), poor compliance with physical activity restriction: 21.1% vs. 9.4% (p = 0.013)].We concluded that early hospital readmission in patients with HF was associated with higher mortality rates. Compared to late rehospitalization, precipitating factors for early rehospitalization were more strongly dependent on the self-care behaviors of the patients. 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