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
verfasst von:
Alberto Esteban-Fernández, Manuel Anguita-Sánchez, Juan Luis Bonilla-Palomas, María Anguita-Gámez, Nicolás Rosillo, Náyade del Prado, José Luis Bernal, Cristina Fernández-Pérez, Inmaculada Fernández-Rozas, Juan José Gómez-Doblas, Julián Pérez-Villacastin, Francisco Javier Elola
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.
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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
verfasst von
Alberto Esteban-Fernández Manuel Anguita-Sánchez Juan Luis Bonilla-Palomas María Anguita-Gámez Nicolás Rosillo Náyade del Prado José Luis Bernal Cristina Fernández-Pérez Inmaculada Fernández-Rozas Juan José Gómez-Doblas Julián Pérez-Villacastin Francisco Javier Elola
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