Nonlinear relationship between the serum uric acid-to-high density lipoprotein cholesterol ratio and short-term readmission in chronic heart failure: a retrospective cohort study.

BACKGROUND: This study aims to examine the relationship between the serum uric acid-to-high density lipoprotein cholesterol ratio (UHR) and short-term readmission risk in patients with heart failure. METHODS: In this retrospective cohort study, we analyzed clinical data from Zigong Fourth People's Hospital (December 2016 to June 2019) using multivariate logistic regression, restricted cubic splines, and subgroup analyses to examine the independent association between UHR and short-term readmission risk. RESULTS: The analysis included 1795 participants, of whom 58.4% were female and 53.7% were aged 60-79 years. Our study showed that an increase of one unit in the UHR was associated with a 275% increase in 28-day readmission risk (OR = 3.75, 95% CI = 1.56-9.01, P = 0.003) after adjusting for potential confounders. The 28-day readmission risk was markedly elevated in the high UHR group (Q4) compared to the low UHR group (OR = 2.38, 95% CI = 1.27-4.45, P = 0.007). The relationship between UHR and 3-month readmission risk showed a similar trend. RCS revealed a significant nonlinear relationship between UHR and readmission risk (28-day P for nonlinearity = 0.038, 3-month P for nonlinearity = 0.018), with inflection points at 2.30 for 28 days and 3 months. Subgroup analyses showed that the association between UHR and readmission risk was stronger among octogenarians and males. Sensitivity analyses confirmed the robustness of our findings. CONCLUSIONS: UHR demonstrated a nonlinear association with short-term readmission risk in heart failure, with an inflection point at 2.30. This association was more pronounced in octogenarians and male patients.