Trends and predictors of hospitalization, readmissions and length of stay in ambulatory patients with heart failure

Rev Clin Esp (Barc). 2013 Jan-Feb;213(1):1-7. doi: 10.1016/j.rce.2012.10.006. Epub 2012 Dec 22.
[Article in English, Spanish]

Abstract

Objectives: Little is known on predictors of hospitalisation in ambulatory patients with chronic heart failure, and known predictors may not apply to Mediterranean countries. Our aim was to document longitudinal trends in hospitalisations and identify patient-related predictors of hospital admission, re-admission and length of stay in the targeted population.

Methods: Population-based retrospective cohort study in Catalonia (North-East Spain), including 7196 ambulatory patients (58.6% women; mean age 76 years). Eligible patients were selected from the electronic patient records of primary care practices, and followed for 3 years.

Results: At 3 years of follow up overall 645 (9.0%) patients had cardiovascular hospitalisation, 37% were readmitted, and median length of stay was 9 (interquartile range 5-17) days. Chronic kidney disease [odds ratio (OR)=1.98 (1.62-2.43)], IHD [OR=1.72 (1.45-2.04)], DM [OR=1.50 (1.27-1.78)] and chronic obstructive pulmonary disease [OR=1.43 (1.16-1.77)] increased the risk for hospitalisation. DM [OR=1.70 (1.22-2.38)], IHD [OR=1.85 (1.33-2.58)] and HTA [OR=1.66 (1.11-2.46)] increased the risk for readmissions. Chronic kidney disease [OR of 2.21 (1.70-2.90)], IHD [OR of 2.19 (1.73-2.77)], DM [OR=1.70 (1.34-2.15)], HTA [OR=1.51 (1.13-2.01)], chronic obstructive pulmonary disease [OR=1.37 (1.02-1.83)] increased the risk for long length of stay in hospital.

Conclusions: Our study identified predictors of hospitalisation, readmissions and long length of stay which can help clinicians and managers to identify high risk patients which should be targeted on service planning and when designing preventive actions.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Heart Failure / complications
  • Heart Failure / therapy*
  • Hospitalization / statistics & numerical data*
  • Hospitalization / trends
  • Humans
  • Length of Stay / statistics & numerical data
  • Length of Stay / trends
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Patient Admission / trends
  • Patient Readmission / statistics & numerical data
  • Patient Readmission / trends
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Spain