Factors associated with readmission in patients with left ventricular assist devices in South Korea.

Abstract

Purpose: Although left ventricular assist devices (LVAD) are increasingly used as a standard treatment for end-stage heart failure, few studies have explored LVAD-related readmissions. This study investigated the factors associated with readmission and nursing documentation in patients with LVAD.

Methods: A retrospective analysis was conducted on electronic medical records of patients who underwent LVAD implantation at a tertiary hospital in South Korea (January 2015-April 2023). Baseline and clinical characteristics and nursing documentation were analyzed using χ² test, Fisher's exact test, t-test, and logistic regression.

Results: Of the 127 patients (mean age 61.31 ± 13.27 years, 81.1% male), 63.3% underwent LVAD implantation as a bridge to heart transplantation, and 85 (67.0%) were readmitted within 104 days. Bivariate analyses identified 17 variables significantly differing between readmission and non-readmission groups. The New York Heart Association (NYHA) class II (OR 7.29), NYHA Class III (OR 47.14), prothrombin time (OR 32.65), and presence of free-text nursing notes (OR 7.58) were significant factors of readmission.

Conclusion: Nurses play a vital role in managing patients and helping to reduce readmission rates. In addition to the NYHA class and prothrombin time this research highlights the critical importance of comprehensive nursing documentation. Specifically, 'free-text nursing notes' capture critical patient events and observations, such as non-sustained ventricular tachycardia, bleeding, and noncompliance, providing valuable insights for clinical decision-making and enhancing patient management to prevent unplanned readmissions. These findings highlight the importance of nursing roles in documentation, patient education, and personalized discharge planning to improve clinical outcomes for patients with LVAD.