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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

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Abstract

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.

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Data availability

Data supporting this study are available from the Spanish Ministry of Health. Access to the data is subject to approval and a data sharing agreement due to ethical and legal reasons.

Abbreviations

CC:

Categories of clinical conditions

MBDS:

Minimum basic data set

CSD:

Circulatory system diseases

HF:

Heart failure

NHS:

National health system

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Funding

This study was carried out thanks to an unconditional grant from Menarini (SEC RECALCAR project). Menarini has not participated in any part of the process of elaboration and submission of the article.

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Authors and Affiliations

  1. Cardiology Service, Hospital Universitario Severo Ochoa, Calle Orellana S/N, 28911, Leganés, Madrid, Spain

    Alberto Esteban-Fernández & Inmaculada Fernández-Rozas

  2. Cardiology Service, Hospital Universitario Reina Sofía, Córdoba, Spain

    Manuel Anguita-Sánchez

  3. Instituto Maimónides para la Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain

    Manuel Anguita-Sánchez

  4. Cardiology Service, Hospital San Juan de la Cruz, Úbeda, Jaén, Spain

    Juan Luis Bonilla-Palomas

  5. Cardiology Service, Hospital Clínico San Carlos, Madrid, Spain

    María Anguita-Gámez & Julián Pérez-Villacastin

  6. Institute for the Improvement of Health Care (IMAS Foundation), Madrid, Spain

    Nicolás Rosillo, Náyade del Prado, Cristina Fernández-Pérez & Francisco Javier Elola

  7. Management Control Service, Hospital Universitario 12 de Octubre, Madrid, Spain

    José Luis Bernal

  8. Preventive Medicine Service, Hospital Universitario 12 de Octubre, Madrid, Spain

    José Luis Bernal

  9. Preventive Medicine Department, Área Sanitaria de Santiago de Compostela y Barbanza, Instituto de Investigación de Santiago, Santiago de Compostela, Spain

    Cristina Fernández-Pérez

  10. Cardiology Service, Hospital Virgen de la Victoria, Málaga, Spain

    Juan José Gómez-Doblas

Authors
  1. Alberto Esteban-Fernández
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  2. Manuel Anguita-Sánchez
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  3. Juan Luis Bonilla-Palomas
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  4. María Anguita-Gámez
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  7. José Luis Bernal
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  8. Cristina Fernández-Pérez
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  12. Francisco Javier Elola
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Contributions

Study design: AEF, MAS, JES. Data review and statistical analysis: NR, NP, JLB, JES. Manuscript writing: AEF, MAS. Review, edit, and acceptance of the manuscript: all the authors.

Corresponding author

Correspondence to Alberto Esteban-Fernández.

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Conflict of interest

The authors declare not to have a conflict of interest with this study.

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Esteban-Fernández, A., Anguita-Sánchez, M., Bonilla-Palomas, J.L. et al. 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. Clin Res Cardiol 112, 1119–1128 (2023). https://doi.org/10.1007/s00392-023-02202-7

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  • DOI: https://doi.org/10.1007/s00392-023-02202-7

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