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Evaluation of the predictors of readmission in Korean patients with heart failure

Title
Evaluation of the predictors of readmission in Korean patients with heart failure
Author
정지은
Keywords
heart failure; Korean; national claims data; predictors; readmission
Issue Date
2017-02
Publisher
WILEY-BLACKWELL
Citation
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS, v. 42, No. 1, Page. 51-57
Abstract
What is known and objective : Various factors contribute to the high rate of readmission among patients hospitalized with heart failure (HF). Determination of these factors is fundamental to identify potential targets for intervention in hospitalized patients. Methods : The retrospective cohort study used a large national insurance database to identify episodes of HF. Clinical information up to 12 months from the index hospitalization was obtained. Depending on their outcome, eligible patients were classified into a 30-day readmission group after discharge or a non-readmission group. Potential predictors of 30-day readmission were categorized by patient, drug therapy and health system utilization factors. Results and discussion : Heart failure was identified in 19 128 inpatients. Of these, 276% were readmitted within 30 days after discharge. The mean Charlson comorbidity index (CCI) score was 52 29 for the readmission group and 43 +/- 25 for the non-readmission group. The strongest predictors included paralysis [adjusted odds ratio (AOR) 227, 95% confidence interval (CI) 197-262], followed by metastatic cancer (AOR 222, 95% CI 181-272) and loop diuretic therapy (AOR 152, 95% CI 129-179). A prescription of ACE inhibitor or angiotensin receptor blocker at discharge was associated with a 17% decreased risk (AOR 083, 95% CI 077-089). What is new and conclusions : Hospitalized patients with HF have a 30-day all-cause readmission rate exceeding a quarter. Post-discharge care should focus on patients with advanced age, acuity of admission, enrolled medical aid, hospitalization exceeding 14 days, higher CCI score, more than 10 prescription drugs at discharge, presence of several comorbidities and loop diuretic therapy, which are independent predictors for 30-day readmission.
URI
https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12471http://repository.hanyang.ac.kr/handle/20.500.11754/100494
ISSN
0269-4727
DOI
10.1111/jcpt.12471
Appears in Collections:
COLLEGE OF PHARMACY[E](약학대학) > PHARMACY(약학과) > Articles
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