{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T22:20:08Z","timestamp":1769120408981,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T00:00:00Z","timestamp":1571097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T00:00:00Z","timestamp":1571097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of\u00a0Hunan Province","doi-asserted-by":"publisher","award":["2017JJ2156"],"award-info":[{"award-number":["2017JJ2156"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Project of Hunan Provincial Education Department","award":["16B157"],"award-info":[{"award-number":["16B157"]}]},{"name":"RenShu foundation of Hunan Provincial People\u2019s Hospital","award":["no.2015-2-11"],"award-info":[{"award-number":["no.2015-2-11"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Several heart failure (HF) risk models exist, however, most of them perform poorly when applied to real-world situations. This study aimed to develop a convenient and efficient risk model to identify patients with high readmission risk within 90\u2009days of HF.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A multivariate logistic regression model was used to predict the risk of 90-day readmission. Data were extracted from electronic medical records from January 1, 2017 to December 31, 2017 and follow-up records of patients with HF within 3\u2009months after discharge. Model performance was evaluated using a receiver operating characteristic curve. All statistical analysis was done using R version 3.5.0.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 350 patients met the inclusion criterion of being readmitted within in 90\u2009days. All data sets were randomly divided into derivation and validation cohorts at a 7\/3 ratio. The baseline data were fairly consistent among the derivation and validation cohorts. The variables most clearly related to readmission were logarithm of serum N-terminal pro b-type natriuretic peptide (NT-proBNP) level, red cell volume distribution width (RDW-CV), and Charlson comorbidity index (CCI). The model had good discriminatory ability (C-statistic\u2009=\u20090.73).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We developed and validated a multivariate logistic regression model to predict the 90-day readmission risk for Chinese patients with HF. The predictors included in the model are derived from electronic medical record (EMR) admission data, making it easier for physicians and pharmacists to identify high-risk patients and tailor more intensive precautionary strategies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-019-0915-8","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T17:30:03Z","timestamp":1571160603000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Electronic medical record-based model to predict the risk of 90-day readmission for patients with heart failure"],"prefix":"10.1186","volume":"19","author":[{"given":"Bo-yu","family":"Tan","sequence":"first","affiliation":[]},{"given":"Jun-yuan","family":"Gu","sequence":"additional","affiliation":[]},{"given":"Hong-yan","family":"Wei","sequence":"additional","affiliation":[]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[]},{"given":"Su-lan","family":"Yan","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9426-3685","authenticated-orcid":false,"given":"Nan","family":"Deng","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"915_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.ahj.2004.08.005","volume":"149","author":"KFJ Adams","year":"2005","unstructured":"Adams KFJ, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005;149:209\u201316.","journal-title":"Am Heart J"},{"key":"915_CR2","first-page":"1","volume":"14","author":"W-W Chen","year":"2017","unstructured":"Chen W-W, Gao R-L, Liu L-S, Zhu M-L, Wang W, Wang Y-J, et al. China cardiovascular diseases report 2015: a summary. J Geriatr Cardiol. 2017;14:1\u201310.","journal-title":"J Geriatr Cardiol"},{"key":"915_CR3","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/s10741-011-9280-0","volume":"17","author":"M Gheorghiade","year":"2012","unstructured":"Gheorghiade M, Pang PS, Ambrosy AP, Lan G, Schmidt P, Filippatos G, et al. A comprehensive, longitudinal description of the in-hospital and post-discharge clinical, laboratory, and neurohormonal course of patients with heart failure who die or are re-hospitalized within 90 days: analysis from the EVEREST trial. Heart Fail Rev. 2012;17:485\u2013509.","journal-title":"Heart Fail Rev"},{"key":"915_CR4","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1161\/CIRCULATIONAHA.112.125435","volume":"126","author":"AS Desai","year":"2012","unstructured":"Desai AS, Stevenson LW. Rehospitalization for heart failure: predict or prevent? Circulation. 2012;126:501\u20136.","journal-title":"Circulation."},{"key":"915_CR5","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/S1388-9842(00)00141-0","volume":"3","author":"S Stewart","year":"2001","unstructured":"Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More \u201cmalignant\u201d than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3:315\u201322.","journal-title":"Eur J Heart Fail"},{"key":"915_CR6","first-page":"e38","volume":"133","author":"D Mozaffarian","year":"2016","unstructured":"Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133:e38\u2013360.","journal-title":"Circulation."},{"key":"915_CR7","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1001\/archinte.168.13.1371","volume":"168","author":"JS Ross","year":"2008","unstructured":"Ross JS, Mulvey GK, Stauffer B, Patlolla V, Bernheim SM, Keenan PS, et al. Statistical models and patient predictors of readmission for heart failure: a systematic review. Arch Intern Med. 2008;168:1371\u201386.","journal-title":"Arch Intern Med"},{"key":"915_CR8","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/MLR.0b013e3181ef60d9","volume":"48","author":"R Amarasingham","year":"2010","unstructured":"Amarasingham R, Moore BJ, Tabak YP, Drazner MH, Clark CA, Zhang S, et al. An automated model to identify heart failure patients at risk for 30-day readmission or death using electronic medical record data. Med Care. 2010;48:981\u20138.","journal-title":"Med Care"},{"key":"915_CR9","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.1001\/jama.2011.1515","volume":"306","author":"D Kansagara","year":"2011","unstructured":"Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M, et al. Risk prediction models for hospital readmission: a systematic review. JAMA. 2011;306:1688\u201398.","journal-title":"JAMA."},{"key":"915_CR10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1001\/jamacardio.2016.0220","volume":"1","author":"QL Huynh","year":"2016","unstructured":"Huynh QL, Negishi K, Blizzard L, Sanderson K, Venn AJ, Marwick TH. Predictive score for 30-day readmission or death in heart failure. JAMA Cardiol. 2016;1:362\u20134.","journal-title":"JAMA Cardiol"},{"key":"915_CR11","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/S0196-0644(00)70006-0","volume":"35","author":"AB Storrow","year":"2000","unstructured":"Storrow AB, Gibler WB. Chest pain centers: diagnosis of acute coronary syndromes. Ann Emerg Med. 2000;35:449\u201361.","journal-title":"Ann Emerg Med"},{"key":"915_CR12","doi-asserted-by":"publisher","unstructured":"Liu X, Guo Y, Li D, Cui Z, Liu Y, Li C, et al. The prevalence and long-term variation of hospital readmission for patients with diabetes in Tianjin, China. Medicine (Baltimore). 2017;96. \n                    https:\/\/doi.org\/10.1097\/MD.0000000000007953\n                    \n                  .","DOI":"10.1097\/MD.0000000000007953"},{"key":"915_CR13","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1016\/j.sapharm.2015.10.004","volume":"12","author":"FK Yam","year":"2016","unstructured":"Yam FK, Lew T, Eraly SA, Lin H-W, Hirsch JD, Devor M. Changes in medication regimen complexity and the risk for 90-day hospital readmission and\/or emergency department visits in U.S. veterans with heart failure. Res Soc Adm Pharm RSAP. 2016;12:713\u201321.","journal-title":"Res Soc Adm Pharm RSAP"},{"key":"915_CR14","doi-asserted-by":"publisher","first-page":"7420738","DOI":"10.1155\/2017\/7420738","volume":"2017","author":"M Kitamura","year":"2017","unstructured":"Kitamura M, Izawa KP, Taniue H, Mimura Y, Imamura K, Nagashima H, et al. Relationship between activities of daily living and readmission within 90 days in hospitalized elderly patients with heart failure. Biomed Res Int. 2017;2017:7420738.","journal-title":"Biomed Res Int"},{"key":"915_CR15","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1002\/ejhf.486","volume":"18","author":"M Schmidt","year":"2016","unstructured":"Schmidt M, Ulrichsen SP, Pedersen L, Botker HE, Sorensen HT. Thirty-year trends in heart failure hospitalization and mortality rates and the prognostic impact of co-morbidity: a Danish nationwide cohort study. Eur J Heart Fail. 2016;18:490\u20139.","journal-title":"Eur J Heart Fail"},{"key":"915_CR16","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373\u201383.","journal-title":"J Chronic Dis"},{"key":"915_CR17","doi-asserted-by":"publisher","first-page":"992","DOI":"10.7326\/0003-4819-140-12-200406150-00008","volume":"140","author":"T Hayashi","year":"2004","unstructured":"Hayashi T, Boyko EJ, Leonetti DL, McNeely MJ, Newell-Morris L, Kahn SE, et al. Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans. Ann Intern Med. 2004;140:992\u20131000.","journal-title":"Ann Intern Med"},{"key":"915_CR18","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.amjcard.2016.10.022","volume":"119","author":"S Sudharshan","year":"2017","unstructured":"Sudharshan S, Novak E, Hock K, Scott MG, Geltman EM. Use of biomarkers to predict readmission for congestive heart failure. Am J Cardiol. 2017;119:445\u201351.","journal-title":"Am J Cardiol"},{"key":"915_CR19","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/S0140-6736(07)61380-4","volume":"370","author":"DM Mannino","year":"2007","unstructured":"Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet Lond Engl. 2007;370:765\u201373.","journal-title":"Lancet Lond Engl"},{"key":"915_CR20","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1016\/j.ijcard.2012.12.091","volume":"168","author":"N Aung","year":"2013","unstructured":"Aung N, Ling HZ, Cheng AS, Aggarwal S, Flint J, Mendonca M, et al. Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure. Int J Cardiol. 2013;168:1997\u20132002.","journal-title":"Int J Cardiol"},{"key":"915_CR21","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1016\/S0140-6736(15)00343-8","volume":"386","author":"L Jiang","year":"2015","unstructured":"Jiang L, Krumholz HM, Li X, Li J, Hu S. Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system. Lancet Lond Engl. 2015;386:1493\u2013505.","journal-title":"Lancet Lond Engl"},{"key":"915_CR22","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1136\/bmj.324.7352.1498","volume":"324","author":"FDR Hobbs","year":"2002","unstructured":"Hobbs FDR, Davis RC, Roalfe AK, Hare R, Davies MK, Kenkre JE. Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: cohort study in representative and high risk community populations. BMJ. 2002;324:1498.","journal-title":"BMJ."},{"key":"915_CR23","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12872-015-0127-9","volume":"15","author":"H Aizawa","year":"2015","unstructured":"Aizawa H, Imai S, Fushimi K. Factors associated with 30-day readmission of patients with heart failure from a Japanese administrative database. BMC Cardiovasc Disord. 2015;15:134.","journal-title":"BMC Cardiovasc Disord"},{"key":"915_CR24","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1016\/j.cardfail.2017.09.014","volume":"23","author":"Y Zhang","year":"2017","unstructured":"Zhang Y, Zhang J, Butler J, Yang X, Xie P, Guo D, et al. Contemporary epidemiology, management, and outcomes of patients hospitalized for heart failure in China: results from the China Heart Failure (China-HF) registry. J Card Fail. 2017;23:868\u201375.","journal-title":"J Card Fail"},{"key":"915_CR25","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.cardfail.2016.04.014","volume":"22","author":"JM Vader","year":"2016","unstructured":"Vader JM, LaRue SJ, Stevens SR, Mentz RJ, DeVore AD, Lala A, et al. Timing and causes of readmission after acute heart failure hospitalization-insights from the heart failure network trials. J Card Fail. 2016;22:875\u201383.","journal-title":"J Card Fail"},{"key":"915_CR26","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.repc.2017.06.020","volume":"37","author":"F Formiga","year":"2018","unstructured":"Formiga F, Moreno-Gonzalez R, Chivite D, Casado J, Escrihuela-Vidal F, Corbella X. Clinical characteristics and one-year mortality according to admission renal function in patients with a first acute heart failure hospitalization. Rev Port Cardiol. 2018;37:159\u201365.","journal-title":"Rev Port Cardiol"},{"key":"915_CR27","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.hfc.2010.03.008","volume":"6","author":"TH Le Jemtel","year":"2010","unstructured":"Le Jemtel TH, Arain S. Mediators of anemia in chronic heart failure. Heart Fail Clin. 2010;6:289\u201393.","journal-title":"Heart Fail Clin"},{"key":"915_CR28","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.hfc.2010.03.007","volume":"6","author":"WHW Tang","year":"2010","unstructured":"Tang WHW, Yeo PSD. Epidemiology of anemia in heart failure. Heart Fail Clin. 2010;6:271\u20138.","journal-title":"Heart Fail Clin"},{"key":"915_CR29","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1001\/jama.281.18.1714","volume":"281","author":"GJ Izaks","year":"1999","unstructured":"Izaks GJ, Westendorp RG, Knook DL. The definition of anemia in older persons. JAMA. 1999;281:1714\u20137.","journal-title":"JAMA."},{"key":"915_CR30","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.ahj.2015.04.006","volume":"170","author":"P Khazanie","year":"2015","unstructured":"Khazanie P, Heizer GM, Hasselblad V, Armstrong PW, Califf RM, Ezekowitz J, et al. Predictors of clinical outcomes in acute decompensated heart failure: acute study of clinical effectiveness of nesiritide in decompensated heart failure outcome models. Am Heart J. 2015;170:290\u20137.","journal-title":"Am Heart J"},{"key":"915_CR31","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.rce.2016.10.003","volume":"217","author":"D Escribano","year":"2017","unstructured":"Escribano D, Santas E, Minana G, Mollar A, Garcia-Blas S, Valero E, et al. High-sensitivity troponin T and the risk of recurrent readmissions after hospitalisation for acute heart failure. Rev Clin Esp. 2017;217:63\u201370.","journal-title":"Rev Clin Esp"},{"key":"915_CR32","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.ijcard.2014.12.004","volume":"181","author":"G Corrao","year":"2015","unstructured":"Corrao G, Ghirardi A, Ibrahim B, Merlino L, Maggioni AP. Short- and long-term mortality and hospital readmissions among patients with new hospitalization for heart failure: a population-based investigation from Italy. Int J Cardiol. 2015;181:81\u20137.","journal-title":"Int J Cardiol"},{"key":"915_CR33","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.rmed.2016.11.013","volume":"123","author":"A Richardson","year":"2017","unstructured":"Richardson A, Tolley E, Hartmann J, Reedus J, Bowlin B, Finch C, et al. \u201cEvaluation of chronic obstructive pulmonary disease (COPD) and reduced ejection fraction heart failure (HFrEF) discharge medication prescribing: is drug therapy concordant with national guidelines associated with a reduction in 30-day readmissions?\u201d [Respir. Med. 119 (October 2016) 135-140]. Respir Med. 2017;123:150.","journal-title":"Respir Med"},{"key":"915_CR34","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/S1388-9842(02)00021-1","volume":"4","author":"JL Alonso-Martinez","year":"2002","unstructured":"Alonso-Martinez JL, Llorente-Diez B, Echegaray-Agara M, Olaz-Preciado F, Urbieta-Echezarreta M, Gonzalez-Arencibia C. C-reactive protein as a predictor of improvement and readmission in heart failure. Eur J Heart Fail. 2002;4:331\u20136.","journal-title":"Eur J Heart Fail"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-019-0915-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12911-019-0915-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-019-0915-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T23:06:03Z","timestamp":1602630363000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/s12911-019-0915-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,15]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["915"],"URL":"https:\/\/doi.org\/10.1186\/s12911-019-0915-8","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,15]]},"assertion":[{"value":"8 January 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study\u2019s protocol was established according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of the First Affiliated Hospital of Hunan Normal University (Hunan Provincial People\u2019s Hospital). All authors have authorized access to electronic medical record data. (approval no. 2018\u201335). Informed consent was exempted by the Ethics Committee because of the retrospective nature of this research. Patient records\/information were anonymized and de-identified prior to analysis.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"193"}}