Factors Associated With Readmission in Patients With Left Ventricular Assist Devices in South Korea

IF 2.3 3区 医学 Q2 NURSING Asian Nursing Research Pub Date : 2025-05-01 DOI:10.1016/j.anr.2024.12.009
Hyeonji Kang , Mona Choi
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Abstract

Purpose

Although left ventricular assist devices (LVADs) 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 LVADs.

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% men), 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 nonreadmission groups. New York Heart Association (NYHA) class II [odds ratio (OR): 7.29], NYHA Class III (OR: 47.14), prothrombin time (OR: 32.65), and the 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 nonsustained 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 LVADs.
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韩国左心室辅助装置患者再入院的相关因素
目的:尽管左心室辅助装置(LVAD)越来越多地被用作终末期心力衰竭的标准治疗方法,但很少有研究探讨LVAD相关的再入院情况。本研究调查了LVAD患者再入院的相关因素和护理记录。方法:回顾性分析韩国某三级医院2015年1月- 2023年4月LVAD植入患者的电子病历。采用χ2检验、Fisher精确检验、t检验和logistic回归分析基线、临床特征和护理资料。结果:127例患者(平均年龄61.31±13.27岁,男性81.1%)中,63.3%的患者接受了LVAD植入作为心脏移植的桥梁,85例(67.0%)在104天内再次入院。双变量分析确定了再入院组和非再入院组之间显着差异的17个变量。纽约心脏协会(NYHA) II级(OR 7.29)、NYHA III级(OR 47.14)、凝血酶原时间(OR 32.65)和自由文本护理笔记的存在(OR 7.58)是再入院的重要因素。结论:护士在管理患者和降低再入院率中起着至关重要的作用。除了NYHA类和凝血酶原时间,这项研究强调了全面的护理文件的重要性。具体而言,“自由文本护理笔记”记录了关键的患者事件和观察结果,如非持续性室性心动过速、出血和不依从性,为临床决策提供了有价值的见解,并加强了患者管理,以防止意外再入院。这些发现强调了护理在文献记录、患者教育和个性化出院计划方面的重要性,以改善LVAD患者的临床结果。
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来源期刊
CiteScore
4.20
自引率
4.50%
发文量
32
审稿时长
45 days
期刊介绍: Asian Nursing Research is the official peer-reviewed research journal of the Korean Society of Nursing Science, and is devoted to publication of a wide range of research that will contribute to the body of nursing science and inform the practice of nursing, nursing education, administration, and history, on health issues relevant to nursing, and on the testing of research findings in practice.
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