Factors affecting hospital readmission heart failure patients in Japan: a multicenter retrospective cohort study

Umehara, Takuya; Katayama, Nobuhisa; Tsunematsu, Miwako; Kakehashi, Masayuki

doi:10.1007/s00380-019-01500-3

Cited by 15 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HFrEF is associated with high hospitalization and mortality [ 25 ]. A clinical study based on Japanese heart failure patients showed that HFrEF was a risk factor for readmission in heart failure patients [ 26 ]. Based on our findings, clinicians can pay more attention to patients aged > 65 years with a diagnosis of HFrEF, such as increasing the frequency of follow-up and the range of monitoring indicators, which may improve clinical outcomes and reduce the risk of readmission.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety analysis of angiotensin receptor neprilysin inhibition(ARNI)in patients with heart failure: a real-world retrospective study

Wang,

Pu,

Wang

et al. 2023

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background In a large randomized controlled trial (PARADIGM-HF), ARNI has been shown to significantly reduce cardiovascular mortality and hospitalization for patients with reduced ejection fraction in heart failure. This study analyzed the efficacy and safety of ARNI on the basis of various types of heart failure patients in southwestern Sichuan Province. Methods This study included patients with heart failure who were treated at the Affiliated Hospital of North Sichuan Medical College from July 2017 to June 2021. This study analyzed the efficacy and safety of ARNI in the treatment of heart failure, and analyzed the risk factors for readmission after ARNI treatment. Results After propensity score matching, a total of 778 patients were included in the study. The readmission rate for heart failure in patients treated with ARNI (8.7%) was significantly lower than that in the standard treatment group (14.5%) (P = 0.023). Both the proportion of patients with increased LVEF and with decreased LVEF were higher in the ARNI treatment group than in the conventional therapy group. Compared with receiving standard medical treatment, combined ARNI treatment resulted in a greater reduction in SBP (-10.00, 95%CI: -24.00-1.50 vs. -7.00, 95%CI: -20.00-4.14; P = 0.016) in HF patients. Combination ARNI therapy did not increase the risk of adverse events. The study found that age (> 65 vs. ≤65 years) (OR = 4.038, 95%CI: 1.360-13.641, P = 0.013) and HFrEF (OR = 3.162, 95%CI: 1.028–9.724, P = 0.045) were independent predictors of readmission in HF patients treated with ARNI. Conclusion Patients with heart failure treated with ARNI can improve clinical symptoms and reduce the risk of readmitted hospital admission. Age > ~ 65 years and HFrEF were independent predictors of readmission in HF patients treated in ARNI group.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and safety analysis of angiotensin receptor neprilysin inhibition(ARNI)in patients with heart failure: a real-world retrospective study

Wang,

Pu,

Wang

et al. 2023

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…In addition, the frailty group had higher rates of diabetes, previous myocardial infarction, and previous PCI/cardiac surgery/previous angina. In this regard, past research has shown that factors such as diabetes mellitus, myocardial infarction, and history of PCI may increase the risk of HF readmission in HF patients [ 21 ], and may thus be confounding factors. However, these studies did not evaluate frailty in this context.…”

Section: Discussionmentioning

confidence: 99%

“…Next, we conducted the Cox proportional hazards regression with one-year readmission set as the objective variable. Based on the outcomes of previous studies, we selected the following dependent variables: sex [19,20], age at implantation (divided into 75 years of age or older and less than 75 years of age [19,20]), left ventricular ejection fraction (more than 50%; heart failure with preserved ejection fraction, more than 40%, less than 50%; heart failure with mid-range ejection fraction, and less than 40%; heart failure with reduced ejection fraction [HFrEF]) [21], kidney failure (estimated glomerular filtration rate < 60%) [22], anemia (hemoglobin < 10 g/dl) [23], hyponatremia (sodium < 135 mEq/L) [24], ischemic or non-ischemic [25][26][27], type of CIED [28], type of implant, and frailty [7]. In cases where variables were significant, we created Kaplan-Meier survival curves and conducted intergroup comparisons using Kaplan-Meier estimators with log-rank tests.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impacts of preoperative frailty on readmission after cardiac implantable electrical device implantation

et al. 2022

View full text Add to dashboard Cite

Cardiac implantable electrical devices (CIED) such as pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapies are generally recommended for older patients and those with severe heart failure (HF). However, there is currently a lack of evidence on the relationship between frailty and readmission rates among patients with CIED. This study investigated whether preoperative frailty influenced readmission rates among patients with CIED over a one-year period following implantation. The study retrospectively analyzed 101 patients who underwent CIED implantations. To compare frailty-based differences in their characteristics and readmission rates, these participants were categorized into frailty and non-frailty groups via the modified frailty index (mFI). The frailty group had a significantly higher readmission rate than the non-frailty group (non-frailty group vs. frailty group = 1 vs. 8 patients: P < 0.05). Further, a multivariate analysis showed that frailty was a significant readmission factor. Based on individual analyses with/without histories of HF, the readmission rate also tended to be higher among individuals considered frail via the mFI (readmission rate in HF patients: non-frailty group vs. frailty group = 1 vs. 5 patients: P = 0.65; non-HF patients: non-frailty group vs. frailty group = 0 vs. 3 patients: P = 0.01). Participants with preoperative frailty showed higher readmission rates within a one-year period following implantation compared to those without preoperative frailty. This tendency was consistent regardless of HF history. The mFI may thus help predict readmission among patients with CIED.

show abstract

“…As a result of the ageing of the population, this percentage is projected to increase steadily over the coming years. A six-month analysis of the reasons for rehospitalization of patients with heart failure by Umehara et al showed that CKD, dementia, and low motor performance were risk factors for rehospitalization [13].…”

Section: Most Common Causes Of Rehospitalizations For Cardiovascular Causesmentioning

confidence: 99%

Long-Term Outpatient Care and Rehospitalizations in Patients after Cardiac Electrotherapy Device Implantation

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Cardiovascular implantable electronic device (CIED) treatment is widely used in modern cardiology. Indications for this type of treatment are increasing. However, a significant proportion of CIED implantation patients require subsequent hospitalization for cardiovascular reasons. Older age and the associated complex clinical picture necessitate multidisciplinary outpatient specialist care for these patients. The aim of this study was to analyze the reasons for subsequent hospitalizations in the cardiology department and the impact of outpatient specialty care on these hospitalizations. To the best of our knowledge, there are no such studies in the available literature. Materials and Methods: This study was conducted on a population of patients treated with CIED. Reasons for subsequent hospitalizations were divided into clinically and statistically valid groups according to the main diagnosis. Using an electronic database, causes of hospitalization were determined based on this diagnosis. Using data on consultations at outpatient specialty clinics, a logistic regression model was created for the probability of subsequent hospitalization for cardiovascular causes according to the specialty of the clinic. Results: The 9-year follow-up included a population of 2071 patients treated with CIED. During the follow-up period, 508 patients (approximately 24.5%) required subsequent hospitalization for cardiovascular reasons. The most common leading causes were heart failure, atrial fibrillation, and coronary artery disease. The need for consultation at outpatient specialty clinics increased the likelihood of hospitalization. Moreover, the need to consult patients in nephrology outpatient, pulmonary disease outpatient, and orthopedic outpatient clinics was the most significant. Conclusions: The use of electronic implantable cardiovascular devices is a very important part of therapy in modern cardiology. The methods for their use are constantly being improved. However, they represent only one stage of cardiac treatment. After CIED procedures, patients require further care in both inpatient and outpatient specialty care settings. In this paper, we outline the reasons for subsequent hospitalizations and the importance of outpatient specialty care in this context. Effective organization of care after CIED procedures may be important in reducing the most expensive component of this care, that is, inpatient treatment.

show abstract

Factors affecting hospital readmission heart failure patients in Japan: a multicenter retrospective cohort study

Cited by 15 publications

References 23 publications

Efficacy and safety analysis of angiotensin receptor neprilysin inhibition(ARNI)in patients with heart failure: a real-world retrospective study

Efficacy and safety analysis of angiotensin receptor neprilysin inhibition(ARNI)in patients with heart failure: a real-world retrospective study

The impacts of preoperative frailty on readmission after cardiac implantable electrical device implantation

Long-Term Outpatient Care and Rehospitalizations in Patients after Cardiac Electrotherapy Device Implantation

Contact Info

Product

Resources

About