Background: Readmission rate for patients with heart failure is reported to be high. Identifying factors that predict readmission of these patients are highly valuable. It can stratify these patients' readmissions and enhance their management strategy. We aim to study readmission predictors for heart failure patients in our Medical Complex in Bahrain.
Methods: Adult patients admitted and discharged with principle diagnosis of heart failure were enrolled. The enrollment period was from January 1st till March 31st, 2012. Follow up was extended to March 31st, 2013. The study was prospective were demographic, clinical, laboratory, length of stay and medications at admission and discharge were collected. Number of readmissions and mortalities was recorded during the follow up period. During each readmission, compliance was verified by direct questioning and follow-up visits attendance monitoring. The above listed clinical parameters were also collected. Basic and advance statistics were conducted using statistical package. Univariate and multivariate regression was done to identify the predictive power of various variables included.
Results: 245 patients were included during the enrollment period. Their mean age was 64 ± 13.5 years. 69% (169 out of 245) were male. Systemic hypertension and diabetes mellitus were found in 73% and 64% respectively (179 and 157 out of 245). During the follow up period 48% (117 out of 245) were readmitted. Mortality was recorded in 9% (23 out of 245). Of the 42 clinical factors studied; 3 were found to be significantly associated with readmission in logistic regression model. A heart rate of 78 beats per minute at discharge with adjusted odd ratio (aOR) 2.36 (95% CI 1.37 - 4.07, p = 0.05), Coronary artery disease aOR 1.81 (95% CI 1.04 - 3.40, p = 0.05) and diabetes mellitus aOR 1.88 (95% CI 1.01 - 3.24, p = 0.05) were the most predictors for mortality and readmissions.
Conclusion: Few clinical variables can predict readmission for heart failure patients. The above identified might represent country or institution specific predictors for heart failure readmission that have to be verified by future studies. It can guide the clinicians to adopt a synchronized approach where cardiac abnormalities, non-cardiac co-morbidities and nation specific factors to be well integrated.