Aims: To compare the predictors of unplanned readmission by primary diagnosis and time since discharge in heart failure (HF) patients.
Methods and results: We used national hospital administrative data for England to analyse unplanned readmission by primary diagnosis (HF and non-HF) at 7, 30, 90, 182, and 365 days after the index discharge. A total of 84 212 adult patients had their first HF admission between April 2008 and March 2010; 14 104 (16.8%) died during the index admission and were excluded. Of the remaining 70 108, half were readmitted and 28.7% died during 1 year from discharge (overall mortality rate of 40.6%). Patients had an average of three co-morbidities. Hierarchical logistic regression showed that arrhythmias [odds ratio (OR) = 1.13] and valvular disease (OR = 1.12) had significantly higher odds only for HF readmission; dementia (OR = 1.29), stroke (OR = 1.29), and mental health conditions (OR = 1.25) had higher odds only for non-HF. Ischaemic heart disease, renal disease, and chronic lung disease predicted both. Same-day discharge occurred for 6% of patients and was strongly associated with higher readmission for HF at 7 days, less so thereafter, and not for non-HF after 7 days. Other relationships changed little between 7 and 365 days. Prior outpatient non-attendance was associated with 5-10% higher odds of any readmission per appointment missed.
Conclusion: In HF patients, some predictors of readmission for HF, especially some common co-morbidities, differ from those for non-HF. In contrast, the time since discharge made little difference to the results.
Keywords: Co-morbidities; Heart failure; Readmissions.
© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.