The Factors Associated With Readmission in One Year Among Patients With Chronic Heart Failure: A Retrospective Cohort Study

Objective This study aimed to identify factors associated with readmission in one year among patients with chronic heart failure (CHF), focusing on the association between medication literacy and readmission. Methods This retrospective cohort study included CHF patients diagnosed and treated at three tertiary hospitals in Hunan, China. The Chi-squared test or Fisher's exact test was used for univariate analysis. Binary logistic regression was applied to identify the factors influencing all-cause readmission within one year. Results A total of 480 CHF patients were included. Of note, 58.1% of them (279 CHF patients) were readmitted to the hospital for any cause within one year. The all-cause readmission rates at one month, three months, six months, and one year were 19.7%, 35.8%, 46.9%, and 58.1%, respectively, while the corresponding proportions for HF readmissions were 10.8%, 20.7%, 28.4%, and 37.6%. Medication literacy was an independent risk factor for one year all-cause readmission (odds ratio (OR)=0.411, 95% confidence interval (CI)=0.134-0.743, p=0.013 ), and the following factors were associated with increased risk of all-cause readmissions within one year: disease duration ≥10 years (OR=5.961, 95% CI=1.981-17.939, p=0.001), myocardial infarction (OR=2.818, 95% CI=1.486-5.344, p=0.002), New York Heart Association Functional Classifications (NYHA class) III (OR=2.794, 95% CI=1.442-5.411, p=0.002), NYHA class IV (OR=4.112, 95% CI=1.952-8.664, p<0.001), and heart failure with mid-range ejection fraction (HFmrEF) (OR=2.463, 95% CI=1.241-4.889, p=0.010). Conclusions Our study found that, in addition to longer disease duration, myocardial infarction, higher NYHA class, and HFmrEF, lower medication literacy may be associated with an increased risk of all-cause readmission in patients with CHF. This new finding provides guidance for the future development of prevention and intervention programs aimed at improving the well-being of CHF patients.