A Latent Class Trajectory Model Based Analysis of KCCQ Symptom Score Trajectories and Readmission Risk in Heart Failure Patients during the Vulnerable Period
10.11714/jsysu.med.YX20260088
- VernacularTitle:基于潜在类别轨迹模型的心力衰竭患者易损期KCCQ症状评分轨迹与再入院风险分析
- Author:
Yuan XU
1
;
Yan JIANG
2
;
Yanan ZHANG
3
;
Hui HU
4
;
Dan XIAO
5
Author Information
1. Department of Artificial Intelligence and Informationization， The Second Affiliated Hospital of Nanchang University， Nanchang 330006， China
2. School of Nursing， Jiangxi Medical College， Nanchang University， Nanchang 330006， China
3. School of Public Health， Jiangxi Medical College， Nanchang University， Nanchang 330019， China
4. Health Management Center， The Second Affiliated Hospital of Nanchang University， Nanchang 330006， China
5. Department of Nursing， The Second Affiliated Hospital of Nanchang University， Nanchang 330006， China
- Publication Type:Journal Article
- Keywords:
heart failure;
vulnerable phase;
KCCQ;
readmission;
latent class trajectory model
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(5):899-912
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months. MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang， China， between August 2020 and July 2025. KCCQ scores were assessed at six time points： day 3 after admission， discharge， and 1， 2， 3， and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk. ResultsDuring follow-up， 229 patients were readmitted， accounting for 20.6% of the cohort. Four KCCQ trajectories were identified： persistently declining scores （n=228， 20.6%）， persistently improving scores （n=110， 9.9%）， stable intermediate scores （n=545， 49.1%）， and stable high scores （n=226， 20.4%）. Compared with the stable intermediate group， the persistently declining group had a higher risk of readmission in the fully adjusted model （OR=2.099， 95% CI： 1.027–4.315， P=0.043）， whereas the stable high-score group had a lower risk （OR=0.260， 95% CI： 0.127–0.494， P<0.001）. The association between the persistently improving trajectory and readmission was not statistically significant （OR=0.614， 95% CI： 0.306–1.154， P=0.147）. ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk， whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.
