Effect of the readmission primary diagnosis and time interval in heart failure patients: analysis of English administrative data

Eur J Heart Fail. 2014 Aug;16(8):846-53. doi: 10.1002/ejhf.129. Epub 2014 Jul 8.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / epidemiology*
  • Case-Control Studies
  • Comorbidity
  • Dementia / epidemiology
  • England / epidemiology
  • Female
  • Heart Failure / epidemiology*
  • Heart Valve Diseases / epidemiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Logistic Models
  • Lung Diseases / epidemiology
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology
  • Patient Readmission / statistics & numerical data*
  • Renal Insufficiency, Chronic / epidemiology
  • Risk Factors
  • Stroke / epidemiology
  • Time Factors
  • Young Adult