Key result
One-year HFpEF readmissions decline ~16% from 2004 to 2011, with no change in HFrEF.
Why the study?
It was unknown whether readmission of HF patients has decreased over time and how trends differ among HFpEF, HFrEF, and HFmrEF.
Cohort (n=20,877)
Yes
While HF-specific readmissions have declined over time in HFpEF, all-cause readmissions remain highest in this group compared to HFrEF and HFmrEF, highlighting the significant burden of non-cardiovascular comorbidities.
Declining HF readmissions in HFpEF may indicate management progress; leaves open whether trends persist or affect all-cause outcomes today.
AIMS: The aim of this study was to investigate whether the readmission of heart failure (HF) patients has decreased over time and how it differs among HF with preserved ejection fraction (EF) (HFpEF) vs. reduced EF (HFrEF) and mid-range EF (HFmrEF). METHODS AND RESULTS: We evaluated HF patients index hospitalized from January 2004 to December 2011 in the Swedish Heart Failure Registry with 1 year follow-up. Outcome measures were the first occurring all-cause, cardiovascular (CV), and HF readmissions. A total of 20 877 HF patients (11 064 HFrEF, 4215 HFmrEF, and 5562 HFpEF) were included in the study. All-cause readmission was the highest in patients with HFpEF, whereas CV and HF readmissions were the highest in HFrEF. From 2004 to 2011, HF readmission rates within 6 months (from 22.3% to 17.3%, P = 0.003) and 1 year (from 27.7% to 23.4%, P = 0.019) in HFpEF declined, and the risk for 1 year HF readmission in HFpEF was reduced by 7% after adjusting for age and sex (P = 0.022). Likewise, risk factors for HF readmission in HFpEF changed. However, no significant changes were observed in all-cause or CV readmission rates in HFpEF, and no significant changes in cause-specific readmissions were observed in HFrEF. Time to the first readmission did not change significantly from 2004 to 2011, regardless of EF subgroup (all P-values > 0.05). CONCLUSIONS: Declining temporal trend in HF readmission rates was found in HFpEF, but all-cause readmission still remained the highest in HFpEF vs. HFrEF and HFmrEF. More efforts are needed to reduce the non-HF-related readmission in patients with HFpEF.
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Cui et al. (2020) conducted a cohort in Heart Failure (n=20,877). Temporal trend (2004-2011) was evaluated on 1-year heart failure readmission in HFpEF (7% risk reduction, p=0.019). Between 2004 and 2011, 1-year heart failure readmission rates in patients with HFpEF declined from 27.7% to 23.4% (P=0.019), whereas no significant changes were observed in HFrEF.
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