Unplanned readmission to hospital and its predictors in heart failure patients, Ethiopia: a retrospective cohort study

Abstract

Background: The burden of heart failure increases over time and is a leading cause of unplanned readmissions worldwide. In addition, its impact has doubled in countries with limited health resources, including Ethiopia. Identifying and preventing the possible contributing factors is crucial to reduce unplanned hospital readmission and to improve clinical outcomes. Method: A hospital-based retrospective cohort study design was employed from January 1, 2016, to December 30, 2020. The data was collected from 572 randomly selected medical records using data extraction checklists. Data were entered in Epi-data version 4.6 and analyzed with Stata version 17. The Kaplan-Meier and log-rank tests were used to estimate and compare the survival failure time. A Cox proportional hazard analysis was computed to identify predictors of readmission. Finally, the statistical significance level was declared at a p-value <0.05 with an adjusted odds ratio and a 95% confidence interval. Result: In this study, a total of 151 (26.40%) heart failure patients were readmitted within 30 days of discharge. In the multivariate cox proportional hazards analysis being an age (>65 years) (AHR: 3.172, 95%CI:.21, 4.55), rural in residency (AHR: 2.47, 95%CI: 1.44, 4.24), Asthma/COPD (AHR: 1.62, 95%CI: 1.11,  2.35), HIV/AIDS (AHR: 1.84, 95%CI: 1.24, 2.75), Haemoglobin level 8-10.9 g/dL (AHR: 6.20, 95%CI: 3.74, 10.28),  and Mean platelet volume >9.1fl (AHR: 2.08, 95%CI: 1.27, 3.40) were identified as independent predictors of unplanned hospital readmission. Conclusion: The incidence of unplanned hospital readmission was relatively high among heart failure patients. Elderly patients, rural residency, comorbidity, higher mean platelet volume, and low hemoglobin level were independent predictors of readmission. Therefore, working on these factors will help to reduce the hazard of unplanned hospital readmission.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Ethical Clearance Letter was obtained from Wollo University's Ethical Review Committee. It has been given an IRB number of CMHS/03/14. Then officials at different levels in the hospitals were communicated through letters, and permission was assured. The data was not disclosed to any person other than the principal investigator. The entire study was conducted as per the declaration of Helsinki's ethical principles for medical research.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

留言 (0)

沒有登入
gif