International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
ISSN-L : 1349-2365
Clinical Studies
Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients
Hidehiro Kaneko, Shinya Suzuki, Masato Goto, Takuto Arita, Yasufumi Yuzawa, Naoharu Yagi, Nobuhiro Murata, Yuko Kato, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Tokuhisa Uejima, Yuji Oikawa, Koichi Sagara, Kazuyuki Nagashima, Hajime Kirigaya, Hitoshi Sawada, Tadanori Aizawa, Junji Yajima, Takeshi Yamashita
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Keywords: Heart rate, Elderly, Diabetes mellitus, Diuretics, Japanese
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2015 Volume 56 Issue 2 Pages 219-225

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Abstract

Repeated hospitalization due to acute decompensated heart failure (HF) is a pandemic health problem in Japan. However, it is difficult to predict rehospitalization after discharge for acute decompensated HF. We used a single hospital-based cohort from the Shinken Database 2004–2012, comprising all new patients (n = 19,994) who visited the Cardiovascular Institute Hospital. A total of 282 patients discharged after their first acute HF admission were included in the analysis. The median follow-up period was 908 ± 865 days. Of these patients, rehospitalization due to worsening HF occurred in 55 patients. The cumulative rate of rehospitalization was 17.5% at 1 year, 21.4% at 2 years, and 25.5% at 3 years. Patients with rehospitalization were older than those without rehospitalization. Prevalence of diabetes mellitus (DM) was more common in patients with rehospitalization. Average heart rate (HR) tended to be higher in patients with rehospitalization. Loop diuretics were more commonly used at hospital discharge in patients with rehospitalization. Multivariate Cox regression analysis revealed that age ≥ 75 years, DM, HR ≥ 75 bpm at discharge, and use of loop diuretics at discharge were independent predictors for rehospitalization. The number of these independent risk factors could be used to clearly discriminate between the HF rehospitalization low-, middle- and high-risk patients. HF rehospitalization commonly occurred in patients who were discharged after their first acute HF admission. Older age, DM, increased HR, and loop diuretics use at discharge were independently associated with HF rehospitalization. By simply counting these risk factors, we might be able to predict the risk of HF rehospitalization after discharge.

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© 2015 by the International Heart Journal Association
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