title: Factors Associated With 7-Day Rehospitalization After Heart Failure Admission.
abstract: BACKGROUND
  Rehospitalizations within 7 days after discharge may reflect the quality of hospital care.
  
  
  OBJECTIVE
  We examined factors associated with 7-day readmissions after discharge for heart failure (HF).
  
  
  METHODS
  Using a matched pair case-control design, we examined health records for sociodemographic, clinical, and health system factors for patients with a primary diagnosis of HF (ICD-10 I50) discharged alive from all acute care hospitals in Calgary, Alberta, from 2004 to 2012. Logistic regression was used to identify variables associated with 7-day all-cause readmission.
  
  
  RESULTS
  We included 382 patients, or 191 in matched pairs, with 41% of readmissions due to HF. Frailty (adjusted odds ratio [aOR], 2.30; 95% confidence interval [CI], 1.41-3.76) and attending physician as specialist (aOR, 2.10; 95% CI, 1.32-3.42) were associated with increased likelihood of readmission. Reduced likelihood of readmission was associated with documented instructions for follow-up with a family physician within 1 week of discharge (aOR, 0.56; 95% CI, 0.36-0.88). All 3 factors were easily abstracted from all patient records, including frailty, which was defined as all 3 of age older than 75 years, 3 or more comorbid conditions, and requiring assistance with activities of daily living.
  
  
  CONCLUSIONS
  Very early readmission to hospital after HF admission is associated with 3 factors that may be easily identified in patient records.
authors.affiliation: Cathy A. Eastwood, RN, PhD Senior Research Associate, Department of Community Health Sciences and Institute of Public Health, University of Calgary, Alberta, Canada. Hude Quan, MD, PhD Professor, Department of Community Health Sciences and Institute of Public Health, University of Calgary, Alberta, Canada. Jonathan G. Howlett, MD Cardiologist and Clinical Professor, Department of Cardiac Sciences and Medicine, Libin Cardiovascular Institute, University of Calgary, Alberta, Canada. Kathryn M. King-Shier, RN, PhD Professor, Faculty of Nursing and Department of Community Health Sciences, University of Calgary, Alberta, Canada.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Eastwood
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Howlett
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: King-Shier
mesh_terms: D000367:Age Factors; D000368:Aged; D000416:Alberta; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index