The Impact of Early Readmission on Subsequent Long-term Clinical Outcomes in Patients Hospitalized for Acute Heart Failure

Background: Heart failure is characterized by high mortality and frequent rehospitalization, and is one of the leading cause for early-discharge readmission. Here, we investigated the impact of short-term HF readmission on subsequent long-term outcomes in patients hospitalized for acute decompensated heart failure (ADHF). Methods and Results: We analyzed the data from 2330 consecutive ADHF patients, who were registered in the West Tokyo Heart Failure (WET-HF) registry and could be followed 90 days after discharge from index hospitalization (38.1% female; median 75 yeast old). During the 0–90 days after discharge, 237 patients [10.2%] had HF readmission, which was defined as early readmission. During 91–730 days of follow-up after discharge, patients with early readmission had higher subsequent all cause death than those without after adjustment for known predictors (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.44 to 2.34). Among the patients with early readmission, older age (HR 1.05, 95% CI 1.02 to 1.07) and lower ejection fraction (HR 0.98, 95% CI 0.96 to 0.99) was associated with subsequent all-cause death. Conclusions: Early readmission after discharge was associated with increased risk of subsequent all-cause mortality in ADHF patients. Among the early readmission patients, age and LV function are independent determinants of worse clinical outcomes. These findings suggest that these vulnerable subgroups should be managed cautiously after discharge.