Analysis Of Factors Related To Readmission Of Elderly Patients With Chronic Heart Failure

Backgroud and Objective:Cardiovascular disease is the number one killer of the elderly,and heart failure is the end-stage of all cardiovascular disease.It is characterized by high mortality,high rehospitalization rate and poor quality of life.Foreign studies suggest that the incidence rate of heart failure in the general population is 0.1%---0.2%,and the prevalence rate is about 1%.It is estimated that the prevalence rate of central force failure in people over 65 years old is about 10%,the mortality rate is about 50% after 5 years of diagnosis of heart failure,and the readmission rate of heart failure patients within 3 to6 months is 27%--50%.Compared with foreign countries,the prognosis of discharged patients with heart failure in China in recent years is not clear,and there is a lack of in-depth discussion on the factors affecting the prognosis of discharged patients with heart failure.Therefore,this study investigated the prognosis and influencing factors of discharged patients with heart failure,so as to provide a new reference for further understanding and improving the prognosis of patients with heart failure.This study by observing repeatedly hospitalized elderly patients with chronic heart failure on admission of hemoglobin,blood lipid,renal function,liver function,NT-proBNP,thyroid function,troponin,myocardial enzyme,electrolyte,echocardiography(LA,LF,EF),cardiac function classification(New York)and so on the change of the level,combined with the patient's gender,age,body mass index,smoking history,regular medication history,and so on,to explore its correlation with the number of heart failure and its clinical significance.Methods:Patients with chronic heart failure diagnosed in the first people's hospital of changde city,hunan province from September 2017 to December 2019 were selected(meeting the diagnostic criteria in the2016 ESC guidelines for the diagnosis and treatment of chronic heart failure).Basic information of the patients was recorded,including name,gender,age,home address,basic diseases,complications(complicated with hypertension,diabetes,infection,digestive system diseases,etc.),biochemical indicators,chest X-ray,heart color doppler ultrasound,admission diagnosis,discharge diagnosis,and disease outcome.The subjects were followed up regularly(including outpatient visits and telephone follow-ups),each time including physical examination,assessment of exercise tolerance,and results of relevant laboratory examinations(blood routine examination,relevant reexamination biochemical indexes,and imaging examinations such as cardiac ultrasonography).Relevant indicators of patients with different hospitalization times were compared and analyzed(data were recorded,processed and statistically analyzed by using Excel 2003,Empower and R software)Results:1.Univariate Logistic regression analysis showed that age,NYHA cardiac function grade,lower limb edema grade,diastolic blood pressure,ejection fraction,uric acid,creatinine,BNP,cholesterol,low-density lipoprotein,thyroid stimulating hormone,lactate dehydrogenase,calcium ion and other influencing factors were all related to the readmission risk of patients with heart failure to varying degrees.2.Univariate Logistic regression analysis showed that age,NYHAcardiac function grade,lower limb edema grade,diastolic blood pressure,ejection fraction,uric acid,creatinine,BNP,cholesterol,low-density lipoprotein,thyroid stimulating hormone,lactate dehydrogenase,calcium ion and other factors were the influencing factors for readmission of patients with heart failure(P < 0.05).3.Multivariate Logistic regression analysis showed that age,lower extremity edema,left ventricular ejection fraction,BNP size,diastolic blood pressure,lactate dehydrogenase,and calcium ion were independent risk factors for readmission to the hospital for heart failure(P < 0.05).The area under the ROC curve was 0.759,and the 95% CI was0.6941-0.8239Conclusions : 1.Patients with the average length of hospital stay,basic heart rate prior to admission,and hemoglobin,platelet,cereal third transaminase,aspertate aminotransferase,D-dimer,blood sugar,CTNI,CK,CK-MB and MB,sodium,potassium and chloride ions,and the heart colour to exceed the report with the size of the left atrium,left ventricle in patients with heart failure readmission risk has no obvious correlation2.Age,NYHA cardiac function grading,lower limb edema grading,left ventricular end-diastolic diameter,ejection fraction,creatinine,uric acid,thyroid stimulating hormone,calcium ion,BNP were positively correlated with the risk of heart failure readadmission.Cholesterol,low density lipoprotein,and lactate dehydrogenase diastolic blood pressure were negatively associated with readmission risk for heart failure.3.Age,lower limb edema,left ventricular ejection fraction,BNP size,diastolic blood pressure level,lactate dehydrogenase and calcium ion concentration were independent risk factors affecting readmission of patients with heart failure.