title: Short- and long-term mortality and hospital readmissions among patients with new hospitalization for heart failure: A population-based investigation from Italy.
abstract: OBJECTIVE
  Predictors of mortality and readmission among patients hospitalized for the first time for heart failure (HF) were investigated for a large, unselected population.
  
  
  METHODS
  The cohort of 13,171 patients in the Lombardy Region (Italy), all of whom were aged 50years or older and survived their first hospitalization for HF during 2011, were followed after discharge. Mortality and readmission within 30days and one year of index discharge were investigated. Kaplan-Meier estimator and Cox model were respectively used to estimate the cumulative proportions of patients experiencing the outcomes and the hazard ratio (HR) for the association between selected covariates and time of outcome onset.
  
  
  RESULTS
  Within 30days of index discharge, 4.7% and 4.3% of the cohort members died or were readmitted for HF, respectively, while 22.6% and 57.2% of them died or were readmitted for any cause within one year of index discharge. Older age was an independent predictor of mortality at both 30days and one year. One-year mortality was affected by the use of diuretics, mineralocorticoid receptor antagonists and antigout preparations and by previous hospitalization for respiratory and cerebrovascular diseases. Younger age, use of antidiabetics, diuretics, other antihypertensives, NSAIDs and antigout preparations and previous hospitalization for renal, respiratory, coronary heart and cerebrovascular disease, were independent predictors of hospital readmission.
  
  
  CONCLUSIONS
  Short- and long-term mortality and readmissions after first hospitalization for HF are high and heterogeneous across different patient subgroups. Characterization of hospitalized HF is very important in assisting clinicians in decision-making and targeting treatment of high-risk patients.
authors.affiliation: Dipartimento di Statistica e Metodi Quantitativi, Sezione di Biostatistica, Epidemiologia e Sanità Pubblica, Università di Milano-Bicocca, Milan, Italy. Electronic address: giovanni.corrao@unimib.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
authors.affiliation: Dipartimento di Statistica e Metodi Quantitativi, Sezione di Biostatistica, Epidemiologia e Sanità Pubblica, Università di Milano-Bicocca, Milan, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Ghirardi
authors.affiliation: Dipartimento di Statistica e Metodi Quantitativi, Sezione di Biostatistica, Epidemiologia e Sanità Pubblica, Università di Milano-Bicocca, Milan, Italy.
authors.forename: Buthaina
authors.initials: B
authors.lastname: Ibrahim
authors.affiliation: Direzione Generale Salute, Unità Organizzativa Governo dei dati, delle strategie e piani del sistema sanitario, Regione Lombardia, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy.
authors.forename: Aldo Pietro
authors.initials: AP
authors.lastname: Maggioni
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors
keywords: Healthcare utilization database; Hospitalized heart failure; Mortality; Predictors; Prognosis