Factors associated with one-year mortality and rehospitalization in patients hospitalized with acute heart failureat Sansai Hospital, Chiang Mai: A retrospective study
Keywords:
acute heart failure, mortality, rehospitalization, clinical predictors, community hospitalAbstract
Background: Acute heart failure is a major public health problem associated with high mortality and readmission rates, particularly in community hospitals with limited resources. The identification of clinical factors associated with adverse outcomes is crucial for planning appropriate patient care and reducing mortality.
Objective: To identify clinical factors associated with in-hospital mortality, one-year mortality, and one-year rehospitalization among patients with acute heart failure admitted to Sansai Hospital, Chiang Mai.
Methods: This retrospective study included 196 patients hospitalized with acute heart failure between January 1 and December 31, 2022 in Sansai Hospital. Clinical characteristics and outcomes were analyzed using univariable and multivariable logistic regression to assess factors associated with mortality and rehospitalization within one year.
Results: Among 196 patients admitted with acute heart failure, 61.7% were female, with a mean age of 69.5 ± 14.6 years. The most common comorbidities were hypertension (51.5%) and diabetes mellitus (39.8%). The in-hospital mortality rate was 9.1% (18 patients), and when including post-discharge deaths within one year, the overall one-year mortality rate was 45.9% (90 patients). The one-year rehospitalization rate was 68.8% (135 patients). In multivariable analysis, factors significantly associated with overall mortality included older age (Adjusted OR 1.03, 95% CI 1.01–1.05, p = 0.003), underweight (BMI <18.5) (Adjusted OR 2.54, 95% CI 1.08–5.95, p = 0.032), and anemia (Hb <10 g/dL) (Adjusted OR 2.62, 95% CI 1.12–6.10, p = 0.026). For rehospitalization, anemia (Hb <10 g/dL) (Adjusted OR 2.11, 95% CI 0.94–4.76, p = 0.071) and underweight (BMI <18.5) (Adjusted OR 1.96, 95% CI 0.88–4.35, p = 0.095) showed a trend toward being associated risk factors.
Conclusion: Patients with acute heart failure in Sansai Hospital experienced higher mortality and rehospitalization rates than those reported in previous national and international studies. Key predictive factors included older age, underweight, and anemia. These findings highlight the need for structured post-discharge follow-up programs, such as dedicated heart failure clinics, to improve long-term outcomes.
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