Clinical characteristics at hospital discharge that predict cardiovascular readmission within 100 days in heart failure patients – An observational study

Abstract

Background: After a heart failure (HF) hospital discharge, the risk of a cardiovascular (CV) related event is highest in the following 100 days. It is important to identify factors associated with increased risk of readmission. Method: This retrospective, population-based study examined HF patients in Region Halland (RH), Sweden, hospitalized with a HF diagnosis between 2017 and 2019. Data regarding patient clinical characteristics were retrieved from the Regional healthcare Information Platform from admission until 100 days post-discharge. Primary outcome was readmission due to a CV related event within 100 days. Results: There were 5029 included patients being admitted for HF and discharged and 1966 (39%) were newly diagnosed. Echocardiography was available for 3034 (60%) patients and 1644 (33%) had their first echocardiography while admitted. The distribution of HF-phenotypes was 33% HF with reduced ejection fraction (EF), 29% HF with mildly reduced EF and 38% HF with preserved EF. Within 100 days, 1586 (33%) patients were readmitted, and 614 (12%) died. A Cox regression model showed that advanced age, longer hospital length of stay, renal impairment, high heart rate and elevated NT-proBNP were associated with an increased risk of readmission regardless of HF-phenotype. Women and increased blood pressure are associated with a reduced risk of readmission. Conclusions: One third had a CV-readmission within 100 days. This study found clinical factors already present at discharge that are associated with increased risk of readmission which should be considered at discharge.

Keywords

• Heart failure
• Hospital readmission
• Risk factors