Biomedical, socioeconomic and demographic predictors of heart failure readmissions : A systematic review

Aims
To identify the biomedical, socioeconomic and demographic predictors of heart failure (HF) related readmissions in adult patients with HF.

Methods
This systematic review was conducted in March 2020 using the databases EMBASE, CINAHL and Medline to identify publications between 2015–2020. The resulting articles were systematically reviewed according to the PRISMA guidelines.

Results
Eighteen (18) studies were included in this review. Unemployment (HR=1.09; 95%CI=1.05–1.14; p=0.03) was the only socioeconomic factor predictive of HF-readmissions. Socio-Economic Indexes for Areas (SEIFA) scores did not predict HF readmissions in adults with HF (p>0.05). All patients included in the studies had pre-existing HF. Based on the included studies, Indigenous status was identified as a risk factor for HF readmissions in 1 study (p<0.05), and age or sex did not affect HF readmission patterns (p>0.05). New York Heart Association (NYHA) class, brain natriuretic peptide (BNP) levels, and heart rate were also predictive of HF readmission (p<0.05). Left ventricular ejection fraction and blood pressure, however, were non-significant risk factors of HF readmissions (p>0.05).

Conclusions
This review identified unemployment, Indigenous status, NYHA class, heart rate, and BNP levels to predict HF related readmissions in adult patients with HF. Adding demographic and socioeconomic variables to readmission risk models has the potential to more accurately target patients at risk of readmissions.