Prevalence of Re-Hospitalization for Heart Failure in a Cameroonian Tertiary Hospital: A Cross-Sectional Study

Aim: To determine the prevalence of re-hospitalization for heart failure in the cardiology unit of the Yaoundé General Hospital. Study Design: This was a retrospective cross-sectional study from January 2015 to December 2020. Patients and Methods: Patients aged at least 18 years who were hospitalized for heart failure during the study period were included. Data were collected using a predesigned form and were analyzed using Epi InfoTM version 7.2.2. Results: We included a total of 160 patients. The prevalence of re-hospitalization was 30.6%. Re-hospitalized patients had a mean age of 71.0 ± 13.9 years and a sex ratio of 1.6. The most common etiologies of HF were hypertensive heart disease (36.7%), followed by dilated cardiomyopathy (22.5%), and atrial fibrillation (16.3%). More than two third had class IV NYHA disease (77.6%). Most of them also had HFrEF (71.4%) and anemia (77.6%). Conclusion: There is a high rate of re-hospitalization in the cardiology unit of the Yaoundé General Hospital with most of these patients having old age and severe HF.

Predictive model of re-hospitalization in patients with coronary artery disease combined with heart failure

Background The number of patients with coronary artery disease(CAD)complicated with heart failure(HF)in China is large,the prognosis is poor,and the re-hospitalization rate is high.This study established a predictive model of re-hospitalization factors for patients with CAD and HF.Methods A total of 326 patients with CAD and HF who were hospitalized in the Department of Cardiology of Guangdong Provincial People.s Hospital from2019 to 2020 and were selected.The medical records of patients were collected by electronic medical record system and followed up for 6 months.Step-wise logistic regression analysis was used to select the potential predictors of re-hospitalization.The risk factors related to re-hospitalization of CAD with HF(P<0.10)were included in the final multivariate logistic regression model.The predictive efficacy of re-hospitalization risk factors for CAD complicated with HF was evaluated by receiver operating characteristic(ROC)curve.Results Re-hospitalization occurred in 83 patients(26%)during the 6-month follow-up.New York Heart Association(NYHA)class(per 1-level increment,adjusted OR:1.45,95%CI:1.14-2.23,P=0.034),smoking(adjusted OR:2.30,95%CI:1.20-4.38,P=0.012),drinking(adjusted OR:2.22,95%CI:1.08-4.56,P=0.029)and the use of statin(adjusted OR:0.50,95%CI:0.25-0.98)were independent predictors of re-hospitalization.The predictors showed a good performance with the area under curve(AUC)of 0.702(95%CI:0.632-0.754).Conclusions This study developed a novel prediction model for re-hospitalization among patients complicated with CAD and HF,which included four easily accessible clinical variables(NYHA class,smoking,drinking and the use of statins).This model provided a theoretical basis for the identification,intervention and treatment of such patients.

Hospital readmissions in decompensated cirrhotics: Factors pointing toward a prevention strategy

AIM To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors.METHODS We performed a single-center retrospective study of patients admitted with decompensated cirrhosis from January 1, 2011 to December 31, 2013(n = 222). Primary outcomes were time to first readmission and 30-d readmission rate due to complications of cirrhosis. Clinical and demographic data were collected to help describe predictors of readmission, along with care coordination measures such as post-discharge status and outpatient follow-up. Univariate and multivariateanalyses were performed to describe variables associated with readmission.RESULTS One hundred thirty-two patients(59.4%) were readmitted at least once during the study period. Median time to first and second readmissions were 54 and 93 d, respectively. Thirty and 90-d readmission rates were 20.7 and 30.1 percent, respectively. Predictors of 30-d readmission included education level, hepatic encephalopathy at index, ALT more than upper normal limit and Medicare coverage. There were no statistically significant differences in readmission rates when stratified by discharge disposition, outpatient follow-up provider or time to first outpatient visit.CONCLUSION Readmissions are challenging aspect of care for cirrhotic patients and risk continues beyond 30 d. More initiatives are needed to develop enhanced, longitudinal post-discharge systems.