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/1.73m2 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.