Factors That Influence 7- and 30-day Readmissions After Heart Failure Hospitalization
Notice bibliographique
Résumé
Patients with heart failure (HF) frequently return to hospital within days of discharge, yet contributing factors have not been fully explored. Hospitalizations place stress on the patient, family, and healthcare system, and require closer examination to determine potential avoidability and targets for intervention. Thus, current factors that influence readmissions after HF hospitalization in Alberta were examined. A two-phased case-control design was used to compare patients who were readmitted and not readmitted after hospitalization for HF. In Phase One, an 8-year period of hospital discharge abstract data was analyzed. The rate of unplanned all-cause readmission was 6% and 18% within 7 and 30 days respectively after discharge. After risk adjustment for age, sex, and year, all-cause readmission within 7 days after discharge was associated with having kidney disease, and readmission within 30 days was associated with having cancer, pulmonary, liver, and kidney disease. At both time intervals, discharge with homecare services was associated with increased risk of readmission, and discharge from a hospital with HF services was associated with lower risk of readmission. In Phase Two, a health record audit was undertaken for a more detailed examination of factors associated with readmission within 7 days of discharge and potential avoidability. Matched pairs of patients discharged from Calgary hospitals were identified from the Phase One sample. Patients who were frail or had a specialist as attending physician were more likely to be readmitted. Patients who were instructed to see a physician within 1 week of discharge were less likely to be readmitted. Common reasons for readmission included HF then gastrointestinal, other cardiac, and respiratory diagnoses. Almost 60% of readmissions were deemed potentially avoidable based on explicit criteria developed from past research. Several factors were associated with readmission within the 2 time intervals studied. Despite care by specialists and referral to HF clinics, complex frail patients were discharged with unresolved symptoms or inadequate community support. It is important that criteria be developed to screen for frailty, discharge readiness, and to determine avoidability.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».