Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study

Abstract Background Heart failure imposes a significant healthcare burden, with early unplanned readmissions post-discharge linked to poor outcomes. Identifying risk factors and their predictive value is crucial for targeted interventions. Objective To investigate gender differences in cumulative ha...

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Main Authors: Lingling Cui, Xiaolei Wei, Tao Liang, Rui Yan, Minyu Du, Tusiyiti Alimire, Yuyang Huang, Hua Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04674-z
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author Lingling Cui
Xiaolei Wei
Tao Liang
Rui Yan
Minyu Du
Tusiyiti Alimire
Yuyang Huang
Hua Wang
author_facet Lingling Cui
Xiaolei Wei
Tao Liang
Rui Yan
Minyu Du
Tusiyiti Alimire
Yuyang Huang
Hua Wang
author_sort Lingling Cui
collection DOAJ
description Abstract Background Heart failure imposes a significant healthcare burden, with early unplanned readmissions post-discharge linked to poor outcomes. Identifying risk factors and their predictive value is crucial for targeted interventions. Objective To investigate gender differences in cumulative hazard function and the factors influencing 30-day unplanned readmissions in heart failure patients, and to compare their predictive value. Methods A prospective study of heart failure patients hospitalized in Beijing Hospital from October 2023 to March 2024. Patients’ nutritional status was assessed using the Mini-Nutritional Assessment Scale Short Version (MNA-SF), frailty was evaluated using the Groningen Frailty Index (GFI), and the Appendicular Skeletal Muscle Mass Index (ASMI) was calculated. Multifactorial Cox regression analysis was conducted, and ROC curves were plotted for predictive modeling. Results A total of 121 heart failure patients (60.3% males), aged (69.87 ± 11.9) years were included. With a median follow-up duration of 30 days, 25 (20.7%) patients with readmission. COX regression analysis stratified by gender showed that age, regular smoking, nutritional status, left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP), GFI, and ASMI were independent predictors of readmission within 30 days in patients with heart failure (P < 0.050). ROC curve analysis showed that age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI individually as well as in combination predicted readmission within 30 days in patients with heart failure; the joint model performed optimally, with an AUC value reaching 0.877 (95%CI 0.801 ∼ 0.952, P < 0.001), with a sensitivity of 0.920 and a specificity of 0.729. Conclusion A multifactorial approach including age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI predicts 30-day readmission risk, offering a basis for clinical intervention strategies to improve patient outcomes.
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spelling doaj-art-dea88c8bf0a442bfad153b3f4e35486e2025-08-20T03:10:09ZengBMCBMC Cardiovascular Disorders1471-22612025-04-0125111110.1186/s12872-025-04674-zFactors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective studyLingling Cui0Xiaolei Wei1Tao Liang2Rui Yan3Minyu Du4Tusiyiti Alimire5Yuyang Huang6Hua Wang7Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesSchool of nursing, Chinese Academy of Medical Sciences and Peking Union Medical CollegeSchool of nursing, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesAbstract Background Heart failure imposes a significant healthcare burden, with early unplanned readmissions post-discharge linked to poor outcomes. Identifying risk factors and their predictive value is crucial for targeted interventions. Objective To investigate gender differences in cumulative hazard function and the factors influencing 30-day unplanned readmissions in heart failure patients, and to compare their predictive value. Methods A prospective study of heart failure patients hospitalized in Beijing Hospital from October 2023 to March 2024. Patients’ nutritional status was assessed using the Mini-Nutritional Assessment Scale Short Version (MNA-SF), frailty was evaluated using the Groningen Frailty Index (GFI), and the Appendicular Skeletal Muscle Mass Index (ASMI) was calculated. Multifactorial Cox regression analysis was conducted, and ROC curves were plotted for predictive modeling. Results A total of 121 heart failure patients (60.3% males), aged (69.87 ± 11.9) years were included. With a median follow-up duration of 30 days, 25 (20.7%) patients with readmission. COX regression analysis stratified by gender showed that age, regular smoking, nutritional status, left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP), GFI, and ASMI were independent predictors of readmission within 30 days in patients with heart failure (P < 0.050). ROC curve analysis showed that age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI individually as well as in combination predicted readmission within 30 days in patients with heart failure; the joint model performed optimally, with an AUC value reaching 0.877 (95%CI 0.801 ∼ 0.952, P < 0.001), with a sensitivity of 0.920 and a specificity of 0.729. Conclusion A multifactorial approach including age, BNP, ASMI, smoking status, LVEF, nutritional status, and GFI predicts 30-day readmission risk, offering a basis for clinical intervention strategies to improve patient outcomes.https://doi.org/10.1186/s12872-025-04674-zHeart failureReadmissionNutritionFrailtyASMI
spellingShingle Lingling Cui
Xiaolei Wei
Tao Liang
Rui Yan
Minyu Du
Tusiyiti Alimire
Yuyang Huang
Hua Wang
Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
BMC Cardiovascular Disorders
Heart failure
Readmission
Nutrition
Frailty
ASMI
title Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
title_full Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
title_fullStr Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
title_full_unstemmed Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
title_short Factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value: a prospective study
title_sort factors influencing unplanned readmission within 30 days in patients with heart failure and their predictive value a prospective study
topic Heart failure
Readmission
Nutrition
Frailty
ASMI
url https://doi.org/10.1186/s12872-025-04674-z
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