European Primary Care Cardiovascular Society

In real-world setting, hospital readmissions are frequent first 3 months post-discharge in HF

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

Literature - Wideqvist M, Cui X, Magnusson C, et al. - ESC Heart Fail. 2021 Feb 17. doi: 10.1002/ehf2.13221.

Introduction and methods

HF is a disease of the elderly and changing demographics of the population cause an increase in absolute numbers of patients with HF [1]. Health care costs due to hospitalizations for HF are high [2,3]. This economic burden is expected to increase further, because a larger number of people is reaching a higher age.

Identification of high-impact users of the health care system (defined as three or more emergency hospital admissions within a year) has been challenging and risk prediction models have various limitations, i.e. they are often based upon results from RCT populations and are therefore an incorrect representative of the general population that develop HF [4,5]. Furthermore, there are limited data about the time-window of and risk factors involved in hospitalization of patients with HF in Sweden. This study assessed the timing of all-cause and HF hospital readmissions and related risk factors in a real-world cohort of patients with HF.

This retrospective study included patients (n=448) who were admitted to the Sahlgrenska University Hospital/Östra in Gothenburg, Sweden in 2016 and who received a primary diagnosis of HF. Patients had to live in the Västra Götaland region. Patients’ characteristics, such as co-morbidities, laboratory parameters, and physical parameters were collected in a pre-specified form. The time to first all-cause or HF readmission at 1 month, 3 months, 6 months, and 1 year and number of readmissions during 1 year were analyzed. Patients were also stratified to the number of co-morbidities to compare the risk of 1 month and 1 year all-cause or HF readmission between patients with >3 co-morbidities and ≤3 co-morbidities. Follow-up was 1 year.

Main results

Conclusion

This 1 year follow-up study of a real-world cohort of patients with HF showed that hospital readmissions frequently occurred early (first quarter) after discharge and were mainly caused by worsening HF. Number of co-morbidities was an important risk factor for readmissions, except for HF readmissions within the first month.

The authors state that many hospital readmissions could be prevented by selectively targeting high-risk patients with HF and directing them towards appropriate interventions.

References

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