Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: A longitudinal observational study

摘要

Aims and objectives To examine the rate of rehospitalisation within 6 months after hospital discharge for patients with chronic heart failure (CHF) and to investigate the potential factors influencing rehospitalisation. Background The rehospitalisation rates of heart failure (HF) patients show large differences from previous studies. It is not clear whether HF patients readmit due to exacerbation of HF or to comorbidities or other diseases. Although many studies have investigated the factors influencing rehospitalisation of HF patients, the impacts of depression and self-care on rehospitalisation in this population remain unclear in China. Design A longitudinal observational study was conducted. The study adheres to the STROBE guideline. Methods Four hundred thirty-two CHF inpatients were recruited by using a convenience sampling method from three tertiary teaching hospitals in Guangzhou, southern China. The scales used included the demographic and clinical questionnaires, the Centre for Epidemiologic Studies Depression Scale, the Self-Care of Heart Failure Index and the Charlson Comorbidity Index. Data were collected at two time points. A binary logistic regression was employed to determine factors associated with rehospitalisation of HF patients. Results The rehospitalisation rate of CHF patients was 23.6% (n = 102) within 6 months after hospital discharge. Of those patients, 74 (72.6%) were readmitted once, 20 patients (19.6%) were readmitted twice and eight patients (7.8%) were readmitted three times. The results from logistic regression showed that CHF patients who maintained self-care behaviours (OR = 0.763, p = 0.026) and had better self-care management (OR = 0.516, p = 0.041) and stronger self-care confidence (OR = 0.854, p = 0.039) were less likely to readmit. The odds of rehospitalisation were 2.239 times higher in HF patients with depressive symptoms (OR = 2.239, p = 0.013) than in those without these symptoms. Compared to patients living alone, those who lived with family members were less likely to be readmitted to hospital (OR = 0.361, p = 0.048). Conclusions Rehospitalisation commonly occurs in CHF patients within 6 months after hospital discharge in China. A lower level of self-care, the presence of depressive symptoms and not living with family members are key determinants that influence rehospitalisation for this population. Relevance to clinical practice Effective measures are required to improve CHF patients' self-care, reduce depressive symptoms and receive full support from family members.