Readmissions and clinical outcomes in heart failure patients: A retrospective study

Background: Heart failure is a syndrome, due to structural and/or functional abnormalities of the heart associated with high mortality and readmissions. Causes of readmissions are poorly understood and identifying the factors associated with readmissions are crucial to reduce poor clinical outcomes in these patients. Objectives: The main objective of this study was to identify the factors associated with readmissions and clinical improvement in heart failure patients. Materials and methods: A case-control study was conducted in South Indian tertiary care teaching hospital from August 2017 to February 2018. Heart failure patients with readmissions (cases) and without readmissions (control) were identified from medical records department patient files using International Classification of Diseases 10 code 150. Patient's demographics, medical history, laboratory parameters, treatment pattern, readmissions and clinical outcome were collected. Factors associated with readmissions and improved clinical outcome were identified by logistic regression. Results: Out of the total 451 heart failure patients 63.6% were male. The mean age of the study population was 59.7 ± 14.1. Hypothyroidism (OR: 2.64; p = 0.041), diabetes mellitus (OR: 1.59; p = 0.019) and hypertension (OR: 1.53; p < 0.034) were identified as statistically significant factors associated with readmissions. Conversion of intravenous to per oral diuretics (OR: 1.98; p = 0.019) and ejection fraction at readmission (OR: 1.04; p = 0.020) were associated with clinical improvement. Conclusions: Comorbidities like hypothyroidism, diabetes mellitus and hypertension were associated with increased readmissions in patients with heart failure in this study.