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. 2021 Apr;8(2):1388-1397.
doi: 10.1002/ehf2.13221. Epub 2021 Feb 17.

Hospital readmissions of patients with heart failure from real world: timing and associated risk factors

Maria Wideqvist  1 , Xiaotong Cui  2 , Charlotte Magnusson  1 , Maria Schaufelberger  1 , Michael Fu  1
Affiliations

Hospital readmissions of patients with heart failure from real world: timing and associated risk factors

Maria Wideqvist et al. ESC Heart Fail. 2021 Apr.

Abstract

Aims: This study aims to investigate hospital readmissions and timing, as well as risk factors in a real world heart failure (HF) population.

Methods and results: All patients discharged alive in 2016 from Sahlgrenska University Hospital/Östra, Gothenburg, Sweden, with a primary diagnosis of HF were consecutively included. Patient characteristics, type of HF, treatment, and follow-up were registered. Time to first all-cause or HF readmission, as well as number of 1 year readmissions from discharge were recorded. In total, 448 patients were included: 273 patients (mean age 78 ± 11.8 years) were readmitted for any cause within 1 year (readmission rate of 60.9%), and 175 patients (mean age 76.6 ± 13.7) were never readmitted. Among readmissions, 60.1% occurred during the first quarter after index hospitalization, giving a 3 month all-cause readmission rate of 36.6%. HF-related 1 year readmission rate was 38.4%. Patients who were readmitted had significantly more renal dysfunction (52.4% vs. 36.6%, P = 0.001), pulmonary disease (25.6% vs. 15.4%, P = 0.010), and psychiatric illness (24.9% vs. 12.0%, P = 0.001). Number of co-morbidities and readmissions were significantly associated (P < 0.001 for all cause readmission rate and P = 0.012 for 1 year HF readmission rate). Worsening HF constituted 63% of all-cause readmissions. Psychiatric disease was an independent risk factor for 1 month and 1 year all-cause readmissions. Poor compliance to medication was an independent risk factor for 1 month and 1 year HF readmission.

Conclusions: In our real world cohort of HF patients, frequent hospital readmissions occurred in the early post-discharge period and were mainly driven by worsening HF. Co-morbidity was one of the most important factors for readmission.

Keywords: Co-morbidities; Heart failure (HF); Readmissions.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Burden of all‐cause or HF readmissions subsequent 1 year after index hospitalization. (A) Readmission rate at different times after discharge from index hospitalization. (B) Distribution of readmissions over the 1 year follow up time.
Figure 2
Figure 2
Relationship between number of co‐morbidities and all‐cause or HF readmissions.
Figure 3
Figure 3
Comparison of incidence of readmission and death by co‐morbidities.
See this image and copyright information in PMC

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