Short- and long-term mortality and hospital readmissions among patients with new hospitalization for heart failure: A population-based investigation from Italy

Objective: Predictors of mortality and readmission among patients hospitalized for the first time for heart failure (HF) were investigated for a large, unselected population. Methods: The cohort of 13,171 patients in the Lombardy Region (Italy), all of whom were aged 50 years or older and survived their first hospitalization for HF during 2011, were followed after discharge. Mortality and readmission within 30 days and one year of index discharge were investigated. Kaplan-Meier estimator and Cox model were respectively used to estimate the cumulative proportions of patients experiencing the outcomes and the hazard ratio (HR) for the association between selected covariates and time of outcome onset. Results: Within 30 days of index discharge, 4.7% and 4.3% of the cohort members died or were readmitted for HF, respectively, while 22.6% and 57.2% of them died or were readmitted for any cause within one year of index discharge. Older age was an independent predictor of mortality at both 30 days and one year. One-year mortality was affected by the use of diuretics, mineralocorticoid receptor antagonists and antigout preparations and by previous hospitalization for respiratory and cerebrovascular diseases. Younger age, use of antidiabetics, diuretics, other antihypertensives, NSAIDs and antigout preparations and previous hospitalization for renal, respiratory, coronary heart and cerebrovascular disease, were independent predictors of hospital readmission. Conclusion: Short- and long-term mortality and readmissions after first hospitalization for HF are high and heterogeneous across different patient subgroups. Characterization of hospitalized HF is very important in assisting clinicians in decision-making and targeting treatment of high-risk patients. (C) 2014 Published by Elsevier Ireland Ltd.