Association Between The Discharge Process And Post-Discharge Events In Patients With Heart Failure

Background: HF is a burden on healthcare resources due to the high cost of frequent readmissions. Predictive models have been reported for the post-discharge prognosis of HF. However, these models mostly included non-modifiable factors and their predictive accuracy was limited. This implies that potentially modifiable factors are needed, which could be attributed to the discharge process. This study aimed to explore the relationship between the discharge process and post-discharge events in patients with HF.Methods: Medical records were reviewed to identify patients who were admitted for HF exacerbation. Information related to the discharge process included post-discharge clinic appointments, educational contents before discharge, and family participation during patient education. HF-related events were defined as a composite of events, including emergency department visits, readmissions, or death. A multivariable Cox proportional hazards regression model was used to explore the association between the discharge process and HF-related events.Results: Of 201 patients, 41 had at least one HF-related event. Post-discharge clinic appointments were scheduled 8 days after discharge. Patients received their discharge education on average of one topic, and approximately the families of 70% of the patients participated in this educational activity. In the Cox regression model, family participation during education was independently associated with a longer time to HF events (hazard ratio: 2.105). However, and post-discharge follow-up appointments and the number of educational contents received were not associated with the time to HF events. Conclusion: We found that family participation during education is a protective factor for adverse prognosis in patients with HF. Our results highlight the importance of family engagement in HF management.