Predictors of 6-month Recurrent Admission or Death in Patients with Acute Decompensated Heart Failure in Police General Hospital

Congestive heart failure (CHF) is highly prevalence in Thailand. Numbers of patients frequently are dead or re-admitted to the hospital after prompt treatment. This problem affects not only the progression of disease and the patient's quality of life but also becomes a burden to the patient's family, hospital and country. Objective: To identify significant risk factors that could predict patients who die or are re-admitted from congestive heart failure during a 6-month follow up after first hospitalization. Patient factors, severity of disease and given therapies were focused on in this study. Methods: The Thai ADHERE registry is a national, multicenter, observational, prospective study where data were collected via a web-based electronic data capture. This retrospective data were collected from the ADHERE registry data base of discharged patients from the Police General Hospital during 2006 - 2007 and follow up data were analyzed. Results: 191 patients hospitalized episodes were enrolled from the Police General Hospital, 91 patients died or were readmitted during the 6-month follow up. By multivariate analysis, history of atrial fibrillation, history of prior stroke or transient ischemic attack and history for the use of nitrates were associated with mortality and readmission during the 6 months of follow up, Odds ratio (OR) = 3.56 (1.54-8.21), 3.16 (1.16-8.59) and 2.20 (1.16-4.20) respectively. While the historical use of an angiotensin converting enzyme inhibitor or angiotensin receptor blocker was associated with better outcomes, OR = 0.36 (0.18-0.70). Conclusion: The patient characteristics, hospital features, processes of medical care predicted the risk of death and hospital readmission for CHF, modification of these risk factors may improve risk classification for heart failure