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

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

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  • 1Department of Primary Care and Public Health, Imperial College London, UK.



To compare the predictors of unplanned readmission by primary diagnosis and time since discharge in heart failure (HF) patients.


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.


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.

© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.


Co-morbidities; Heart failure; Readmissions

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