Factors Responsible for Re-Admission of the Heart Failure Patients in a Tertiary Care Hospital

Abstract

Background: Heart failure is a life threating disease and managing the condition is considered as a health priority globally. At present over 23 million people worldwide are living with Heart failure. Despite of the burden in healthcare due to repeated admission, the level of awareness is not yet satisfactory. Therefore, the aim of the present study was to evaluate the various factors responsible for re-admission of patients with heart failure in a tertiary care hospital.

Methodology: The study was a hospital based prospective cross sectional descriptive study and was conducted at the Department of Cardiology in BIRDEM General Hospital, for six months following approval of this protocol. People who were suffering from Heart failure and admitted in the aforementioned department for the second time and onwards were approached for inclusion in the study. Written informed consent were taken from the subject and ethical issues were ensured. Total 100 subjects were interviewed and data collection were done by using a structured questionnaire & personal file analysis. Following completion of data collection and verification, it were analyzed by the SPSS 21.

Result: Out of total 100 HF patients, 51% were male and 49% were female. Mean age 61.36±14.23 SD (years) with age range 32-98 years. About 55% came from urban area and 45% came from rural area. About 59% of the patients belongs to >40,000 taka monthly followed by 29% with income 21,000-40,000 taka, 6% with 10,000-20,000 taka per month and 6% with <10,000 taka/month. Most of the patients had class IV heart failure (35%) at readmission, followed in decreasing order by class III (28%), class II (21%) and class I (16%). Dyspnea and basal crepitation in lungs were the most frequent presentation, which were present in all most all of the cases. Among them 49% had dyspnoea on ordinary activity, 35% had on rest and 16% had on exertion. Palpitation and anemia was second (62%) and third (59%) in terms of occurrence. Mean pulse, SBP and DBP were 102±15.93 SD (rate/min), 126.1±34.46 SD (mm Hg) and 76.2±16.92 SD (mm Hg), respectively. The most common cause of readmission with heart failure was pulmonary infection (32%), followed by inadequate drug therapy (18%), arrhythmia (12%), other infections (12%), poor compliance (9%) and insufficient professional help (3%).

Conclusion: Pulmonary infection, inadequate drug therapy, arrhythmia, other form of infections and poor compliance are the factors responsible for re-admission of the heart failure patients.

Bangladesh J Medicine 2026; Vol. 37, No. 2(1): pp. 229