One-year readmissions for circulatory diseases and in-hospital mortality after an index episode of heart failure in elderly patients. A nationwide data from public hospitals in Spain between 2016 and 2018
Introduction Heart failure (HF) is one of the leading causes of hospitalization and death in elderly patients. However, there is limited evidence on readmission and mortality 1-year after discharge for HF. Methods Retrospective analysis of the Minimum Basic Data Set, including HF episodes, discharged from Spanish hospitals between 2016 and 2018 in ≥ 75 years. We calculated: (a) the rate of readmissions due to circulatory system diseases (CSD) 365 days after index episode; (b) in-hospital mortality in readmissions; and (c) predictors of mortality and readmission. Results We included 178,523 patients (59.2% women) aged 85.1 ± 5.5 years. The most frequent comorbidities were arrhythmias (56.0%) and renal failure (39.5%). During the follow-up, 48,932 patients (27.4%) had at least one readmission for CSD and a crude rate of 40.2%, the most frequent one HF (52.8%). The median between the date of readmission and discharge from the last admission was 70 days [IQI 24; 171] for the first readmission. The most relevant predictors of the number of readmissions were valvular heart disease and myocardial ischemia. During the readmissions, 26,757 patients (79.1%) died, representing a cumulative in-hospital mortality of 47,945 (26.9%). The factors in the index episode predictors of mortality during readmissions were cardio-respiratory failure and stroke. The number of readmissions was a risk factor for in-hospital mortality (OR 1.13; 95% CI 1.11–1.14). Conclusions The readmission rate for CSD 1-year after the index episode of HF in patients ≥ 75 years was 28.4%. The cumulative in-hospital mortality rate during the readmissions was 26.9%, and the number of rehospitalizations was identified as one of the main predictors of mortality. Graphical abstract.
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Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:112 |
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| Enthalten in: |
Clinical research in cardiology - 112(2023), 8 vom: 11. Apr., Seite 1119-1128 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Esteban-Fernández, Alberto [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Elderly patients |
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| Anmerkungen: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00392-023-02202-7 |
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| PPN (Katalog-ID): |
OLC2144573999 |
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| 245 | 1 | 0 | |a One-year readmissions for circulatory diseases and in-hospital mortality after an index episode of heart failure in elderly patients. A nationwide data from public hospitals in Spain between 2016 and 2018 |
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| 520 | |a Introduction Heart failure (HF) is one of the leading causes of hospitalization and death in elderly patients. However, there is limited evidence on readmission and mortality 1-year after discharge for HF. Methods Retrospective analysis of the Minimum Basic Data Set, including HF episodes, discharged from Spanish hospitals between 2016 and 2018 in ≥ 75 years. We calculated: (a) the rate of readmissions due to circulatory system diseases (CSD) 365 days after index episode; (b) in-hospital mortality in readmissions; and (c) predictors of mortality and readmission. Results We included 178,523 patients (59.2% women) aged 85.1 ± 5.5 years. The most frequent comorbidities were arrhythmias (56.0%) and renal failure (39.5%). During the follow-up, 48,932 patients (27.4%) had at least one readmission for CSD and a crude rate of 40.2%, the most frequent one HF (52.8%). The median between the date of readmission and discharge from the last admission was 70 days [IQI 24; 171] for the first readmission. The most relevant predictors of the number of readmissions were valvular heart disease and myocardial ischemia. During the readmissions, 26,757 patients (79.1%) died, representing a cumulative in-hospital mortality of 47,945 (26.9%). The factors in the index episode predictors of mortality during readmissions were cardio-respiratory failure and stroke. The number of readmissions was a risk factor for in-hospital mortality (OR 1.13; 95% CI 1.11–1.14). Conclusions The readmission rate for CSD 1-year after the index episode of HF in patients ≥ 75 years was 28.4%. The cumulative in-hospital mortality rate during the readmissions was 26.9%, and the number of rehospitalizations was identified as one of the main predictors of mortality. Graphical abstract | ||
| 650 | 4 | |a Elderly patients | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Readmission | |
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| 650 | 4 | |a One-year follow-up | |
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| 700 | 1 | |a Pérez-Villacastin, Julián |4 aut | |
| 700 | 1 | |a Elola, Francisco Javier |4 aut | |
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