One-year Readmission And Related Factors Among Patients With Coronary Heart Disease

ObjectivesTo describe one-year readmission among patients with coronary heart disease (CHD), and exploring associated factors of the readmission.MethodsConvenience sampling was used to select 296 patients with coronary heart disease in cardiovascular units from a tertiary referral hospital in Zibo. Clinical data (such as age, gender, body mass index, family history and previous history, etc) and relevant laboratory data (such as heart rate, blood pressure, blood glucose, BNP, Hs-CRP, etc) of participants were collected from medical records. And influence factors based on health ecology model were collected by face to face interview before patients’discharge using the questionnaire, including the number of hospitalized in the past 1 years, family income per month, depression index, the habit of exercise, diet, follow-up, medication compliance, the number of community health service utilization and its satisfaction 3 months before hospitalization etc. All statistical analyses were performed using SPSS 21.0 software package. T test, rank sum test and Chi-square test and logistic regression were used in this study. Statistical significance was accepted at the P < 0.05 level.Results1. A total of 296 patients with coronary heart disease were enrolled in this study,122(41.22%) has experienced of one-year readmission.2. Individual factors:Older than 65, having family history and previous history of Cardiovascular disease and Diabetes can increase the probability of readmission (P<0.05). Higher than normal in BNP and Hs-CRP can increase the probability of readmission (P<0.05)3. Psychological and behavior factors:The less frequency of measurement of pulse or heart rate can increase the probability of readmission(P<0.05); and the coronary artery hrombolysis, percutaneous coronary intervention, coronary artery bypass grafting heart disease treatment experiences, can decrease the probability of readmission (P <0.05)4. Social factors:Living alone can increase the probability of readmission (P=0.001)5. Living and working conditions:The working condition of being in job can decrease the probability of readmission (P<0.05),6. Community health service factors:Have a lower satisfaction with community health service and not choosing community health service when patient feel slightly sick, all can increase the probability of readmission (P<0.05)7. Logistic regression analysis shown that:Older than 65, having family history and previous history of Cardiovascular disease and Diabetes, having a higher HsCRP level, and a lower satisfaction withon the otherwise, community health services, can increase the probability of readmission; Having coronary artery hrombolysis, percutaneous coronary intervention or coronary artery bypass grafting heart disease treatment experiences, can decrease the probability of readmission. Conclusion1. The rate of one-year readmission among patients with coronary heart disease is 41.22% that is higher than the relevant reports whatever from national or international.2. Factors associated with one-year readmission among patients with coronary heart disease including:Older than 65, having family history and previous history of Cardiovascular disease and Diabetes, having a higher HsCRP level, and a lower satisfaction withon the otherwise, community health services increase the probability of readmission; Having coronary artery hrombolysis, percutaneous coronary intervention or coronary artery bypass grafting heart disease treatment experiences, decrease the probability of readmission.