Predictors of 90-day Readmission After Hospitalization in Heart Failure with Reduced Ejection Fraction Patients: A Single-Centre Analytical Cohort Retrospective Study
- 1Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- 2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Indonesia
Abstract
Background: Heart failure with Reduced Ejection Fraction (HFrEF) is a chronic condition frequently associated with recurrent hospitalizations. These readmissions compromise patient outcomes and impose significant burdens on healthcare systems. Identifying high-risk HFrEF patients enables treatment optimization. This single-center analytical study investigates predictors of 90-day readmission after hospitalization in HFrEF patients.
Methods: This retrospective cohort study enrolled patients with Left Ventricular Ejection Fraction (LVEF) ?40% who were admitted to the Cardiology Department Emergency Room at Adam Malik General Hospital for Acute Decompensated Heart Failure (ADHF) from January 2023 to January 2025 using consecutive sampling, followed for 90 days post-discharge. Statistical analyses included Mann-Whitney U, independent t-tests, chi-square, and backward stepwise multivariate logistic regression.
Results: Of 180 patients (71 rehospitalized, 109 non-rehospitalized), multivariate analysis identified five independent predictors of 90-day readmission: Length of Stay (LOS) >7 days (p<0.001, OR 7.854, 95% CI 3.216-19.179), prior Chronic Kidney Disease (CKD) (p=0.008, OR 3.989, 95% CI 1.430-11.131), lower LVEF (p<0.001, OR 0.844, 95% CI 0.777-0.916), Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitor non-use (p=0.006, OR 0.116, 95% CI 0.025-0.544), and lower admission Hemoglobin (Hb) (p=0.028, OR 0.803, 95% CI 0.661-0.976). Kaplan-Meier analysis revealed significant differences in 90-day rehospitalization-free survival across clinical subgroups. Rehospitalized patients had a median survival of 42 days versus 72 days for non-rehospitalized patients (log-rank p<0.001). SGLT2 inhibitor users during index hospitalization showed the strongest curve separation despite a small sample (n=4 vs n=15; log-rank p=0.002), while prolonged LOS >7 days, CKD, and anemia independently predicted worse outcomes (all log-rank p<0.001).
Conclusions: In HFrEF patients, longer LOS >7 days, prior CKD, lower LVEF, lower admission Hb, and lack of inpatient SGLT2 inhibitor use independently predicted 90-day readmission.
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BibTeX
@article{ridwan2026predictors,
title = {{Predictors of 90-day Readmission After Hospitalization in Heart Failure with Reduced Ejection Fraction Patients: A Single-Centre Analytical Cohort Retrospective Study}},
author = {Ariq Athallah Ridwan and Yuke Sarastri},
journal = {Majalah Kardiologi Indonesia},
year = {2026},
month = oct,
doi = {10.30701/ijc.2072},
url = {https://doi.org/10.30701/ijc.2072},
note = {CC BY},
}
RIS
TY - JOUR
TI - Predictors of 90-day Readmission After Hospitalization in Heart Failure with Reduced Ejection Fraction Patients: A Single-Centre Analytical Cohort Retrospective Study
AU - Ariq Athallah Ridwan
AU - Yuke Sarastri
PY - 2026
DA - 2026/10/25
JO - Majalah Kardiologi Indonesia
DO - 10.30701/ijc.2072
UR - https://doi.org/10.30701/ijc.2072
AB - Background: Heart failure with Reduced Ejection Fraction (HFrEF) is a chronic condition frequently associated with recurrent hospitalizations. These readmissions compromise patient outcomes and impose significant burdens on healthcare systems. Identifying high-risk HFrEF patients enables treatment optimization. This single-center analytical study investigates predictors of 90-day readmission after hospitalization in HFrEF patients. Methods: This retrospective cohort study enrolled patients with Left Ventricular Ejection Fraction (LVEF) ?40% who were admitted to the Cardiology Department Emergency Room at Adam Malik General Hospital for Acute Decompensated Heart Failure (ADHF) from January 2023 to January 2025 using consecutive sampling, followed for 90 days post-discharge. Statistical analyses included Mann-Whitney U, independent t-tests, chi-square, and backward stepwise multivariate logistic regression. Results: Of 180 patients (71 rehospitalized, 109 non-rehospitalized), multivariate analysis identified five independent predictors of 90-day readmission: Length of Stay (LOS) >7 days (p<0.001, OR 7.854, 95% CI 3.216-19.179), prior Chronic Kidney Disease (CKD) (p=0.008, OR 3.989, 95% CI 1.430-11.131), lower LVEF (p<0.001, OR 0.844, 95% CI 0.777-0.916), Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitor non-use (p=0.006, OR 0.116, 95% CI 0.025-0.544), and lower admission Hemoglobin (Hb) (p=0.028, OR 0.803, 95% CI 0.661-0.976). Kaplan-Meier analysis revealed significant differences in 90-day rehospitalization-free survival across clinical subgroups. Rehospitalized patients had a median survival of 42 days versus 72 days for non-rehospitalized patients (log-rank p<0.001). SGLT2 inhibitor users during index hospitalization showed the strongest curve separation despite a small sample (n=4 vs n=15; log-rank p=0.002), while prolonged LOS >7 days, CKD, and anemia independently predicted worse outcomes (all log-rank p<0.001). Conclusions: In HFrEF patients, longer LOS >7 days, prior CKD, lower LVEF, lower admission Hb, and lack of inpatient SGLT2 inhibitor use independently predicted 90-day readmission.
SN - 0126-3773
SN - 2620-4762
ER -