The study of incidences and risk factors of re-hospitalization due to heart failure within 30 days after discharge at Thawung Hospital, Lopburi Province in 2013-2016
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Abstract
Background: Heart failure is one of health and economic problems in the world. The study of re-hospitalization of heart failure patients has had a few researches and all of them were studied at tertiary-care hospitals, thereby, no research at secondary-care. As heart failure is mostly the cause of death and re-hospitalization at Thawung hospital so this study showed incidences and risk factors of re-hospitalization, leading to identification of community problems and relevant knowledge in the future. Objectives: To study incidences and risk factors of re-hospitalization of heart failure patients. Materials and method: This study is a retrospective cohort study, using secondary data from patients diagnosed with heart failure and admitted to Thawung Hospital in January 2013 to June 2016. Data analysis by Kaplan-Meier risk was used to analyze the event-free probability and Cox proportional hazards regression to identify risk factors. Results: The incidence of re-hospitalization within 30 days is 19 patients (11.58%). The event-free probability at the end of study was 0.65. Sixty-eight point nine percent of patients showed no recorded causes of heart failure. Echocardiogram was performed only in 45 patients. chronic kidney disease (Hazard ratio in readmission group, 10.83; 95% confidential interval: 3.51-33.46; p < 0.001), age under 60 years old (HR = 3.15; 95%CI: 1.02-9.77; p = 0.047), the length of stay in the hospital of more than 5 days (HR = 4.49; 95%CI: 1.19-17.0; p = 0.027), a clopidogrel usage (HR = 5.68; 95%CI: 1.87-17.31; p = 0.002) and a warfarin usage (HR = 21.18; 95%CI: 3.18-141.22; p = 0.002) are significant risk factors of re-admission within 30 days. Conclusion: Heart failure patients have an event-free probability of rehospitalization = 35%. The strong risk factors consist of patient with age < 60 years old, chronic kidney disease, patients with the length of stay of more than 5 days, a clopidogrel usage, and a warfarin usage.
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