Factors associated with readmission after long-term administration of tolvaptan in patients with congestive heart failure.
10.4103/singaporemedj.SMJ-2021-348
- Author:
Shoko YAMASHITA
1
;
Miki TAKENAKA
2
;
Masayuki OHBAYASHI
2
;
Noriko KOHYAMA
2
;
Tatsuya KURIHARA
3
;
Tomiko SUNAGA
4
;
Hisaaki ISHIGURO
5
;
Mari KOGO
2
Author Information
1. Department of Pharmacy, New Tokyo Hospital, Chiba, Japan.
2. Division of Pharmacotherapeutics, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan.
3. Division of Natural Medicine and Therapeutics, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan.
4. Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.
5. Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
- Publication Type:Journal Article
- MeSH:
Humans;
Tolvaptan/therapeutic use*;
Heart Failure/drug therapy*;
Male;
Female;
Patient Readmission/statistics & numerical data*;
Aged;
Retrospective Studies;
Aged, 80 and over;
Middle Aged;
Glomerular Filtration Rate;
Adult;
Antidiuretic Hormone Receptor Antagonists/therapeutic use*;
Risk Factors;
Kaplan-Meier Estimate;
Multivariate Analysis
- From:Singapore medical journal
2024;65(11):614-623
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:We investigated the factors associated with readmission in patients with congestive heart failure (HF) receiving long-term administration of tolvaptan (TLV) to support treatment decisions for HF.
METHODS:This retrospective cohort study included 181 patients with congestive HF who received long-term administration of TLV. Long-term administration of TLV was defined as the administration of TLV for 60 days or longer. The outcome was a readmission event for worsening HF within 1 year after discharge. Significant factors associated with readmission were selected using multivariate analysis. To compare the time to readmission using significant factors extracted in a multivariate analysis, readmission curves were constructed using the Kaplan-Meier method and analysed using the log-rank test.
RESULTS:The median age was 78 years (range, 38-96 years), 117 patients (64.6%) were males, and 77 patients (42.5%) had a hospitalisation history of HF. Readmission for worsening HF within 1 year after long-term TLV treatment occurred in 62 patients (34.3%). In the multivariate analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 (odds ratio, 3.22; 95% confidence interval, 1.661-6.249; P = 0.001) was an independent significant factor. When eGFR at discharge was divided into two groups (eGFR < 30 vs. eGFR ≥ 30), readmission rates within 1 year were 53.3% vs. 25.4%, respectively ( P = 0.001).
CONCLUSION:We revealed that eGFR was strongly associated with readmission in patients with HF who received long-term administration of TLV. Furthermore, we showed that eGFR is an important indicator in guiding treatment of HF in patients receiving TLV.
