关键词: 慢性心力衰竭, 再入院, 影响因素

Abstract: Objective To explore the current situation of readmission in patients with chronic heart failure and analyze its influencing factors,so as to provide the reference for reducing the risk of readmission. Methods Patients with chronic heart failure hospitalized in a hospital in Qingdao City from January 2019 to December 2021 were selected for this survey. Demographic data,cardiac function grading data,and related physiological and biochemical test results before discharge were collected,and readmission follow-up within 1 year of discharge was carried out. Descriptive analysis method was used to describe readmission status,univariate and multivariate analysis methods were used to analyze the relevant factors of readmission. Results A total of 2 229 patients with chronic heart failure were included as the study subjects. During a one-year follow-up period after discharge,9 died and 4 were lost to follow-up. Finally,2 216 patients were included,of whom 59.61% were males and 40.39% were females,aged 49-91,with a course of disease of 0.1-13 years,and mainly 5-10 years （35.29%）. During the one-year follow-up period,973 cases were readmitted,with a readmission rate of 43.91%. Among them,372 cases （16.79%） were readmitted within 3 months after discharge,and 889 cases （40.12%） were readmitted within 6 months. The Cox regression model analysis showed that age （HR=1.895）,living alone （HR=1.793）,course of disease （HR=3.053）,cardiac function grading at discharge （HR=11.462）,LVEF≤35% （HR=3.518）,complicated with renal insufficiency （HR=6.801）,malnutrition （HR=5.058）,elevated brain natriuretic peptide （HR=6.190）,anemia （HR=6.373）,depression （HR=3.435）,medication adherence （HR=0.107）,low sodium and water limited diet （HR=0.159）,and regular aerobic exercise （HR=0.209） were independent influencing factors that affect readmission of patients with chronic heart failure within one year of follow-up after discharge. Conclusions Patients with chronic heart failure have a high risk of short-term readmission,which is mainly concentrated in 3-6 months after discharge. Attention should be paid to high-risk groups such as the elderly,living alone,with a long course of disease,and complicated with renal insufficiency and anemia. Patients should be encouraged to adhere to a low-salt diet and regular aerobic exercise lifestyle after discharge,and cultivate good medication adherence and maintain a good attitude. Thus,the risk of readmission can be effectively reduced and the quality of life can be improved.

Key words: Chronic heart failure, Readmission, Influencing factor