Therapeutics and Clinical Risk Management (2019-11-01)

Analysis Of Re-Hospitalizations For Patients With Heart Failure Caused By Coronary Heart Disease: Data Of First Event And Recurrent Event

  • Tian J,
  • Yan J,
  • Zhang Q,
  • Yang H,
  • Chen X,
  • Han Q,
  • Han R,
  • Ren J,
  • Zhang Y,
  • Han Q

Journal volume & issue
Vol. Volume 15
pp. 1333 – 1341

Abstract

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Jing Tian,1 Jingjing Yan,2 Qing Zhang,1 Hong Yang,2 Xinlong Chen,1 Qiang Han,2 Rui Han,1 Jia Ren,1 Yanbo Zhang,2,3 Qinghua Han1 1Department of Cardiology, The 1st Hospital of Shanxi Medical University, Taiyuan, Shanxi Province 030001, People’s Republic of China; 2Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province 030001, People’s Republic of China; 3Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Taiyuan, Shanxi Province 030001, People’s Republic of ChinaCorrespondence: Qinghua HanDepartment of Cardiology, The 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, Shanxi Province 030001, People’s Republic of ChinaTel +86 3100113031Fax +86 351 4867146Email [email protected] Yanbo ZhangDepartment of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001, People’s Republic of ChinaTel/fax +86 3543985051Email [email protected]: The re-hospitalization rate of patients with heart failure remains at a high level, and studies of the subject have focused mainly on event-time outcomes. In addition to using re-hospitalization data with the outcomes of the event-time-count, this study introduces the conditional frailty model, which could help obtain more reasonable results.Materials and methods: This prospective observational cohort study enrolled 1484 patients with heart failure caused by coronary heart disease. The outcomes of heart failure readmissions and the case report form data were collected. Based on the traditional Cox model with event-time outcomes, the mixed effects of a conditional frailty model were added to analyze the event-time-count longitudinal data.Results: The Cox regression model showed that non-manual work, diastolic dysfunction, and better medical compensation increased the risk of heart failure readmission, whereas treatment with beta-blockers decreased the risk. The conditional frailty model further revealed that age, female sex, non-manual work, better medical compensation, longer QRS duration, and treatment with percutaneous coronary intervention increased the risk of heart failure readmission.Conclusion: This study obtained more reliable, reasonable results based on longitudinal data and a mixed model. The results could provide more clinical epidemiological evidence for the management of heart failure.Keywords: heart failure, coronary heart disease, re-hospitalization, conditional frailty model

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