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

Abstract

AbstractBackgroundThe 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.MethodA 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.ResultIn 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.ConclusionThe 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.