TỶ LỆ VÀ CÁC YẾU TỐ LIÊN QUAN TỚI TÁI NHẬP VIỆN HOẶC TỬ VONG Ở NGƯỜI BỆNH SUY TIM CẤP TẠI BỆNH VIỆN THỐNG NHẤT

Abstract

Background: Acute heart failure (AHF) represents the leading cause of hospitalization for people over 65 years of age along with the high rate of mortality and readmission and is the main determinant (approximately 70%) of the huge healthcare expenditure related to heart failure. Objective: To investigate the prevalence and related factors of the 30-day and 90-day hospital readmission or mortality in patients with AHF at Thong Nhat hospital. Materials and Methods: This retrospective, descriptive cross-sectional study involved 106 patients who were diagnosed with AHF or acute decompensation of chronic heart failure (ADHF) from 1^st of January 2018 to 31^st of December 2019 and could be collected sufficient information about their events of hospital readmission or mortality in 30 days and 90 days after discharge. Data concerning clinical features, paraclinical investigations, drug use, and information about hospital readmission or mortality were collected from medical records and telephone surveys. Results: The median age of patients was 78 years (interquartile range [IQR], 67 – 84), and 49,1% were women. The readmission or mortality rates were 34,9% within 30 days and 56,6% within 90 days after discharge. The univariate logistic regression analysis found that patients aged over 65 years, with acute coronary syndrome (ACS), and NT-proBNP level at admission and at discharge over 3000 ng/mL elevated the odds of readmission or mortality within 30 days after discharge (ORs were 3,71; 3,06; 2,39 and 3,49, respectively); those who presented in the “warm-wet” hemodynamic category had a 63% decrease in that odd (OR 0,37; 95% CI 0,14 – 0,94; P = 0,038) compared with “warm-dry”. Odds of readmission or mortality within 90 days of discharge in patients with NT-proBNP level at admission over 3000 pg/mL were higher than others (OR 2.68; 95% CI 1.19 – 6,06; P = 0,018). Conclusion: The rates of hospital readmission or mortality in patients within 30 days and 90 days with AHF remained high. The factors including old age, coexistence of ACS, hemodynamic profile, NT-proBNP level at admission and at discharge should be considered as the indicators to be monitored during the treatment to reduce rehospitalization or mortality in patients with AHF.