心力衰竭患者出院30天内再入院的影响因素分析

Analysis on influencing factors of readmission in patients with heart failure within 30 days after discharged

目的调查心力衰竭患者30 d内再入院的现状,分析影响因素。方法选取3129例心力衰竭患者作为调查对象,对其入院一般情况及出院出院30 d内情况进行随访调查,并应用单因素分析与Logistic回归分析方法进行患者出院30 d内再入院影响因素分析。结果出院30 d内有713例患者(22.79%)发生再入院。Logistic回归分析显示:糖尿病(OR=2.168,95%CI:1.246~3.656)、肾功能不全(OR=2.289,95%CI:1.413~3.712)、急性心肌梗死(OR=2.576,95%CI:1.275~5.126)、住院时间(OR=2.014,95%CI:1.146~3.325)是患者再入院的危险因素;出院后护理状况(OR=0.564,95%CI:0.316~0.848)是患者再入院的保护因素。结论心力衰竭患者出院30 d内再入院率较高,受糖尿病、肾功能不全、急性心肌梗死、住院时长及出院后护理状况等因素影响,需要及早对其进行干预以降低患者再入院的发生率。

Objective To investigate the present situation of readmission in 30 days for discharged patients with heart failure and analyze its influencing factors.Method Choose 3129 patients with heart failure and make follow-up interview on general condition of the patients on admission and within 30 days after discharge.Analyze the influencing factors of readmission within 30 days after discharge by single factor analysis and Logistic regression analysis.Result 713 patients(22.79%)are readmitted to hospital in 30 days after discharge.Logistic regression analysis shows that diabetes(OR=2.168,95%CI:1.246~3.656),renal insufficiency(OR=2.289,95%CI:1.413~3.712),acute myocardial infarction(OR=2.576,95%CI:1.275~5.126),hospitalization duration(OR=2.014,95%CI:1.146~3.325)are influencing factors of readmission.Good nursing status(OR=0.564,95%CI:0.316~0.848)after discharge is the protective factor of readmission.Conclusion The readmission rate of patients with heart failure is high within 30 days after discharge,which is affected by diabetes,renal insufficiency,acute myocardial infarction,length of stay and post-discharge nursing status,and so on,so early intervention is needed to reduce the incidence of patient readmission.