title: Predictors of early readmission or death in elderly patients with heart failure.
abstract: BACKGROUND
  Contemporary heart failure (HF) patients are elderly and have a high rate of early rehospitalization or death, resulting in a high burden for both the patients and the health care system. Prior studies were focused on younger and less well-characterized patients. We aimed to identify predictors of early hospital readmission and death in elderly patients with HF.
  
  
  METHODS
  Patients with chronic HF taking part in the TIME-CHF study (n = 614, age 77 +/- 8 years, 41% female, left ventricular ejection fraction 35% +/- 13%) were evaluated with respect to predictors of hospital readmission or death 30 and 90 days after inclusion. Demographic, clinical, laboratory, echocardiographic, and social variables were obtained at baseline and included in a multivariable logistic regression analysis to identify predictors of early events.
  
  
  RESULTS
  The rate of hospital readmission or death was high at 30 (11%) and 90 days (26%). The reason for hospitalization was HF in 33%, other cardiovascular in 32%, and noncardiovascular in 45% of the cases, respectively. Predictors of readmission or death at 30 days were angina, lower systolic blood pressure, anemia, more extensive edema, higher creatinine levels, and dry cough; and at 90 days were coronary artery disease, prior pacemaker implantation, high jugular venous pressure, pulmonary rales, prior abdominal surgery, older age, and depressive symptoms.
  
  
  CONCLUSIONS
  Early hospital readmission or death was frequent among elderly HF patients. A very large proportion of readmissions were due to noncardiovascular causes. In addition to clinical signs of HF, comorbidities are important predictors of early events in elderly HF patients.
authors.affiliation: Department of Cardiology, University Hospital Basel, Basel, Switzerland. muzzarellis@uhbs.ch
authors.forename: Stefano
authors.initials: S
authors.lastname: Muzzarelli
authors.forename: Gregor
authors.initials: G
authors.lastname: Leibundgut
authors.forename: Micha T
authors.initials: MT
authors.lastname: Maeder
authors.forename: Hans
authors.initials: H
authors.lastname: Rickli
authors.forename: Rolf
authors.initials: R
authors.lastname: Handschin
authors.forename: Marc
authors.initials: M
authors.lastname: Gutmann
authors.forename: Urs
authors.initials: U
authors.lastname: Jeker
authors.forename: Peter
authors.initials: P
authors.lastname: Buser
authors.forename: Matthias
authors.initials: M
authors.lastname: Pfisterer
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Brunner-La Rocca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D013318:Stroke Volume