Heart failure drug classes and 30-day unplanned hospital readmission among patients with heart failure in Ethiopia.

IF 1.2 Q4 PHARMACOLOGY & PHARMACY
Birhanu Ayenew, Prem Kumar, Adem Hussein, Yegoraw Gashaw, Mitaw Girma, Abdulmelik Ayalew, Beza Tadesse
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Abstract

Background: Drug therapy is a crucial aspect of heart failure management and has been shown to reduce morbidity and mortality in heart failure patients. However, the comparative effects of these drug classes on readmission rates have not been well studied. Therefore, the aim of this study was to examine the association between different classes of heart failure drugs and 30-day readmission rates in patients with heart failure.

Method: A multicenter, hospital-based retrospective cohort design was employed and 572 randomly selected patients with heart failure were included. Data were entered in Epi-data version 4.6 and analyzed with STATA version 17. Kaplan-Meier and log-rank tests were used to estimate and compare survival time. A Cox proportional hazard model was utilized, employing both bi-variable and multi-variable analyses, to examine the effect of predictors on the timing of unplanned hospital readmissions. The strength of the association was assessed using an adjusted hazard ratio (aHR), and statistical significance was declared for p-values < 0.05 and a 95% confidence interval (CI).

Results: 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 year) (AHR: 2.34, 95%CI: 1.63, 3.37), rural in residency (AHR: 1.85, 95%CI: 1.07, 3.20), hospital stays > 7 Days (AHR: 3.68, 95%CI: 2.51,5.39), discharge with Diuretics (AHR: 2.37, 95%CI: 1.45, 3.86), and discharge with Beta-Blocker (AHR: 0.48, 95%CI: 0 0.34, 0.69) were identified as independent predictors of unplanned hospital readmission.

Conclusion: Elderly patients, being in rural areas, longer hospital stays, and discharges of patients on diuretics and not on beta-blockers were independent predictors of unplanned hospital readmission. Therefore, working on these factors will help to reduce the hazard of unplanned hospital readmissions, improve patient outcomes, and increase the efficiency of heart failure management.

埃塞俄比亚心力衰竭患者的心力衰竭药物分类和30天意外再入院。
背景:药物治疗是心力衰竭治疗的一个重要方面,已被证明可以降低心力衰竭患者的发病率和死亡率。然而,这些药物类别对再入院率的比较效果尚未得到很好的研究。因此,本研究的目的是研究不同类型的心力衰竭药物与心力衰竭患者30天再入院率之间的关系。方法:采用多中心、以医院为基础的回顾性队列设计,随机选取572例心力衰竭患者。数据在Epi-data版本4.6中输入,并使用STATA版本17进行分析。Kaplan-Meier检验和log-rank检验用于估计和比较生存时间。采用Cox比例风险模型,采用双变量和多变量分析来检验预测因子对非计划再入院时间的影响。使用校正风险比(aHR)评估其相关性,p值具有统计学意义。结果:在本研究中,共有151例(26.40%)心力衰竭患者在出院后30天内再次入院。在多因素cox比例风险分析中,年龄(> 65岁)(AHR: 2.34, 95%CI: 1.63, 3.37)、居住在农村(AHR: 1.85, 95%CI: 1.07, 3.20)、住院时间> 7天(AHR: 3.68, 95%CI: 2.51,5.39)、出院时使用利尿剂(AHR: 2.37, 95%CI: 1.45, 3.86)和出院时使用β受体阻滞剂(AHR: 0.48, 95%CI: 0.34, 0.69)被确定为意外再入院的独立预测因素。结论:老年患者、居住在农村地区、住院时间较长、使用利尿剂而非β受体阻滞剂的患者出院是意外再入院的独立预测因素。因此,研究这些因素将有助于减少意外再入院的危险,改善患者的预后,并提高心力衰竭管理的效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
29
审稿时长
8 weeks
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