Incidence and influencing factors of 30-day unplanned readmission in chronic heart failure patients: a systematic review and meta-analysis

Abstract

Objective: Systematic review and meta-analysis of the incidence and risk factors for 30-day unplanned readmissions in patients with chronic heart failure(CHF). Methods: We searched PubMed, Embase, Web of Science, Scopus, Medline, CINAHL, and Chinese databases up to February 2025. Data were analyzed by using Stata 17.0. Results: Among 4,040 screened publications, 21 studies were included. The incidence of 30-day unplanned readmission in CHF patients was 17.7% (95% CI: 13.9%–21.5%). Age ≥65 years (OR = 1.35, P = 0.024), diagnosed with chronic kidney disease (CKD) (OR = 1.26, P = 0.000), diabetes (OR = 1.49, P = 0.001), atrial fibrillation (AF) (OR = 1.12, P = 0.005), coronary heart disease (CHD) (OR = 5.28, P = 0.000), cardiomyopathy (OR = 1.44, P = 0.000), NYHA class ≥Ⅲ or Ⅳ (OR = 1.64, P = 0.000), use of beta blockers (OR = 1.25, P = 0.000), loop diuretics (OR = 1.41, P = 0.004), thiazides (OR = 1.22, P = 0.000), LVEF < 40% (OR = 1.44, P = 0.000), and length of stay (LOS) (OR = 1.16, P = 0.000) were risk factors for 30-day unplanned readmission in CHF patients. Conclusions: The incidence of 30-day unplanned readmissions in patients with CHF is moderate but concerning. Accurate identification of identified risk factors for targeted interventions to reduce the need for readmissions. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024610843, PROSPERO CRD42024610843.