title: Determinants of early readmission after hospitalization for heart failure.
abstract: BACKGROUND
  Determination of factors increasing the likelihood of early readmission after hospitalization for heart failure (HF) is fundamental for identifying potential targets for intervention. Thus, we studied the characteristics of patients readmitted within 7 and 30 days after hospitalization for HF in Alberta, Canada.
  
  
  METHODS
  Using hospital discharge abstract data, we followed patients with incident HF discharged from April 2004-March 2012 and determined their readmission status within 7 and 30 days after an index hospitalization. Logistic regression was used to determine variables associated with readmission.
  
  
  RESULTS
  Of 18,590 patients with HF (49.8% women; mean age 76.4 years), 5.6% were readmitted within 7 days and 18% were readmitted within 30 days. Readmission rates within 7 and 30 days increased significantly with age. Seven-day all-cause readmissions were associated with history of kidney disease (adjusted odds ratio [aOR], 1.28; 95% confidence interval [CI], 1.08-1.53), and 30-day all-cause readmissions were associated with cancer, pulmonary, liver, and kidney disease. Discharge with home care services at the time of discharge was a risk factor for readmission within 7 days (aOR, 1.26; 95% CI, 1.07-1.49) and 30 days (aOR, 1.23; 95% CI, 1.11-1.35). Discharge from a hospital with HF services was associated with lower readmission at both 7 days (aOR, 0.65; 95% CI, 0.57-0.74) and 30 days (aOR, 0.71; 95% CI, 0.65-0.77).
  
  
  CONCLUSIONS
  Several factors were associated with increased risk of readmission, whereas patients discharged from hospitals with HF services had a lower risk of readmission within 7 and 30 days of discharge. The interaction of provision of home care and higher early readmission deserves further study.
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Eastwood
authors.affiliation: Departments of Cardiac Sciences and Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Howlett
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: King-Shier
authors.affiliation: Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
authors.affiliation: Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ezekowitz
authors.affiliation: Department of Community Health Sciences and Institute of Public Health, University of Calgary, Calgary, Alberta, Canada. Electronic address: hquan@ucalgary.ca.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000416:Alberta / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data