Temporal trends in first rehospitalisation for heart failure between 1997 and 2017. trends in hospitalization characteristics and prognostic impact

Neurohormonal blockade/modulation has improved life expectancy in HF, but it is unknown whether the time between a first hospitalisation for HF and the first rehospitalisation has increased.

To investigate temporal trends of time between first hospitalisation for HF and first rehospitalisation for HF.

Using nationwide registers, 43,176 patients with a first hospitalization of HF during 1997–2017 were included. Temporal trends in a) time to first rehospitalisation for HF and b) mortality and rehospitalisation for HF after first rehospitalisation for HF were investigated, as was length of stay and inpatient mortality during first rehospitalisation. Rehospitalisation within 30 days was considered the same event as the index diagnosis.

Between 1997 and 2017, the time between first hospitalisation for HF and first rehospitalisation increased from a median of 351 days to 464 days. During first rehospitalisation for HF, the median length of stay decreased from 6 days to 3 days, in-hospital death decreased from 10% to 6%, and the 90-day absolute risk of death after rehospitalisation decreased from 25% to 19% (Figure 1). After the first rehospitalisation for HF, the 1-year age-standardized mortality and HF rehospitalisation rates decreased, during 1997–2017, from 43 to 30/100-person and 35 to 25/100-person, respectively (Figure 2). Reductions in 5-year mortality and HF hospitalization were also observed. After discharge, an increasing number of patients were started on ACE-I or ARB (1997–2017: 73.7%–79.4%), beta-blockers (1997–2017: 33.7%–83.0%), and MRAs (1997–2017: 43.1%–49.7%) within 90 days after hospitalisation.

Between 1997 and 2017, the median time from first hospitalisation to first rehospitalisation for HF increased by 100 days, while the length of stay and in-hospital death during hospitalisation for HF decreased markedly. 1-year and 5-year mortality and HF rehospitalisation rates after first rehospitalisation for HF also decreased between 1997 and 2017.

Type of funding sources: None.