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

Drug therapy Ethiopia Heart failure Hospital readmission

Journal

Journal of pharmaceutical health care and sciences
ISSN: 2055-0294
Titre abrégé: J Pharm Health Care Sci
Pays: England
ID NLM: 101672177

Informations de publication

Date de publication:
27 Nov 2023
Historique:
received: 16 06 2023
accepted: 20 11 2023
medline: 28 11 2023
pubmed: 28 11 2023
entrez: 28 11 2023
Statut: epublish

Résumé

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. 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). 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. 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.

Sections du résumé

BACKGROUND 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 METHODS
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 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 CONCLUSIONS
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.

Identifiants

pubmed: 38012803
doi: 10.1186/s40780-023-00320-y
pii: 10.1186/s40780-023-00320-y
pmc: PMC10680257
doi:

Types de publication

Journal Article

Langues

eng

Pagination

49

Informations de copyright

© 2023. The Author(s).

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Auteurs

Birhanu Ayenew (B)

Department of Adult Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia. birhanua2015@gmail.com.

Prem Kumar (P)

Department of Adult Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

Adem Hussein (A)

Department of Adult Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

Yegoraw Gashaw (Y)

Department of Pediatric and Child Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia.

Mitaw Girma (M)

Department of Comprehensive Health Nursing, College of Medicine & Health Sciences, Wollo University, Dessie, Ethiopia.

Abdulmelik Ayalew (A)

Department of Adult Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

Beza Tadesse (B)

Department of Adult Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

Classifications MeSH