Precipitants of Hospital Readmission in Chronic Heart Failure: A Cross-Sectional Study from a Tertiary Care Hospital in Bangladesh

Background: Readmission places a substantial clinical and economic burden on patients with chronic heart failure (HF), yet evidence on its precipitants in Bangladesh is scarce. Objective: To recognize the principal precipitants of hospital readmission among adults with chronic HF and to describe their clinical profile at readmission. Methods: This cross-sectional study enrolled 100 adults with established chronic HF receiving anti-failure therapy who were readmitted to the Department of Cardiology, BIRDEM General Hospital, Dhaka, over six months. Sociodemographic characteristics, comorbidities, clinical presentation, New York Heart Association (NYHA) class and the principal precipitant of readmission were recorded by face-to-face interview, examination and record review. Proportions are reported with Wilson 95% confidence intervals (CIs). Results: Mean age was 61.4 ± 14.2 years and 51% were men. Coronary artery disease (94%), hypertension (59%) and anemia (59%) were the leading comorbidities, and 63% were in NYHA class III–IV at readmission. Pulmonary infection was the commonest precipitant (32%; 95% CI 23.7–41.7), followed by inadequate drug therapy (18%), arrhythmia (12%), other infections (12%), poor compliance (9%) and insufficient professional help (3%); 14% had miscellaneous precipitants. Overall, infection accounted for 44% (95% CI 34.7–53.8) and therapy-, adherence- or care-related factors for 30% (95% CI 21.9–39.6) of readmissions. Median HF duration was 18 months (range 5–120). Conclusion: Nearly three-quarters of HF readmissions were triggered by infection or by suboptimal therapy, adherence and follow-up, all potentially preventable. Infection prevention, optimization of guideline-directed therapy and structured post-discharge care should be priorities for reducing HF readmission in Bangladesh.