Comparative analysis of risk factors for rehospitalization in older heart failure patients with and without a history of heart failure hospitalization: insights from a multicenter rehabilitation cohort

Risk factors associated with readmission due to worsening heart failure (HF) after discharge may differ between patients with and without a history of HF hospitalization. This study aimed to identify the risk factors for HF readmission in older patients with and without a history of HF hospitalization.

A total of 899 older inpatients who underwent cardiac rehabilitation were enrolled from a multicenter retrospective cohort study. Patients were classified based on their history of hospitalization for HF, and 1-year HF readmission was investigated. During the 1-year follow-up period, 27.8% were readmitted for HF: 18.7% and 39.7% in those without and with a history of HF hospitalization, respectively. Multivariable regression analysis identified beta-blocker prescription at discharge [hazard ratio (HR): 0.624, 95% confidence interval (CI): 0.410–0.950] and discharge to home (HR: 1.993, 95% CI: 1.026–3.872) as significant risk factors in the group without a history of HF hospitalization. Hemoglobin (HR: 0.896, 95% CI: 0.802–0.997, per 1 g/dL increase) and estimated glomerular filtration rate (e-GFR) levels (HR: 0.987, 95% CI: 0.976–0.998, per 1 mL/min/1.73 m² increase) were significant risk factors in the group with a history of HF hospitalization.

In older patients without a history of HF hospitalization, the absence of a beta-blocker prescription at discharge and direct discharge to home were risk factors for 1-year HF readmission. Lower hemoglobin and e-GFR levels were predictive of readmission in patients with a history of HF hospitalization.