title: Trends and predictors of hospitalization, readmissions and length of stay in ambulatory patients with heart failure.
abstract: OBJECTIVE
  Little is known on predictors of hospitalisation in ambulatory patients with chronic heart failure, and known predictors may not apply to Mediterranean countries. Our aim was to document longitudinal trends in hospitalisations and identify patient-related predictors of hospital admission, re-admission and length of stay in the targeted population.
  
  
  METHODS
  Population-based retrospective cohort study in Catalonia (North-East Spain), including 7196 ambulatory patients (58.6% women; mean age 76 years). Eligible patients were selected from the electronic patient records of primary care practices, and followed for 3 years.
  
  
  RESULTS
  At 3 years of follow up overall 645 (9.0%) patients had cardiovascular hospitalisation, 37% were readmitted, and median length of stay was 9 (interquartile range 5-17) days. Chronic kidney disease [odds ratio (OR)=1.98 (1.62-2.43)], IHD [OR=1.72 (1.45-2.04)], DM [OR=1.50 (1.27-1.78)] and chronic obstructive pulmonary disease [OR=1.43 (1.16-1.77)] increased the risk for hospitalisation. DM [OR=1.70 (1.22-2.38)], IHD [OR=1.85 (1.33-2.58)] and HTA [OR=1.66 (1.11-2.46)] increased the risk for readmissions. Chronic kidney disease [OR of 2.21 (1.70-2.90)], IHD [OR of 2.19 (1.73-2.77)], DM [OR=1.70 (1.34-2.15)], HTA [OR=1.51 (1.13-2.01)], chronic obstructive pulmonary disease [OR=1.37 (1.02-1.83)] increased the risk for long length of stay in hospital.
  
  
  CONCLUSIONS
  Our study identified predictors of hospitalisation, readmissions and long length of stay which can help clinicians and managers to identify high risk patients which should be targeted on service planning and when designing preventive actions.
authors.affiliation: Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, The Netherlands, Instituto Universitario Avedis Donabedian FAD, Universitat Autònoma de Barcelona, Spain, Red de investigación en servicios de salud en enfermedades crónicas REDISSEC, Spain. fad@fadq.org
authors.forename: E
authors.initials: E
authors.lastname: Frigola-Capell
authors.forename: J
authors.initials: J
authors.lastname: Comin-Colet
authors.forename: J
authors.initials: J
authors.lastname: Davins-Miralles
authors.forename: I
authors.initials: I
authors.lastname: Gich-Saladich
authors.forename: M
authors.initials: M
authors.lastname: Wensing
authors.forename: J M
authors.initials: JM
authors.lastname: Verdú-Rotellar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data / Q000639:trends; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain