{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:32:43Z","timestamp":1771471963693,"version":"3.50.1"},"reference-count":36,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,1,4]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify factors that independently predict the risk of rehospitalisation and death after acute heart failure (AHF) hospital discharge in a real-world setting, considering death without rehospitalisation as a competing event.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Single-centre, retrospective, observational study enrolling 394 patients discharged from an index AHF hospitalisation. Overall survival was evaluated using Kaplan-Meier and Cox regression models. For the risk of rehospitalisation, survival analysis considering competing risks was performed: rehospitalisation was the event of interest, and death without rehospitalisation was the competing event.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the first year after discharge, 131 (33.3%) patients were rehospitalised for AHF and 67 (17.0%) died without being readmitted; the remaining 196 patients (49.7%) lived without further hospitalisations. The 1-year overall survival estimate was 0.71 (SE=0.02). After adjusting for gender, age and left ventricle ejection fraction, the results showed that the risk of death was higher in patients with dementia, higher levels of plasma creatinine (PCr), lower levels of platelet distribution width (PDW) and at Q4 of red cell distribution width (RDW). Multivariable models showed that the risk of rehospitalisation was increased in patients with atrial fibrillation, higher PCr or taking beta-blockers at discharge. Furthermore, the risk of death without AHF rehospitalisation was higher in males, those aged \u226580 years, patients with dementia or RDW at Q4 on admission (compared with Q1). Taking beta-blockers at discharge and having a higher PDW on admission reduced the risk of death without rehospitalisation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>When assessing rehospitalisation as a study endpoint, death without rehospitalisation should be considered a competing event in the analyses. Data from this study reveal that patients with atrial fibrillation, renal dysfunction or taking beta-blockers are more likely to be rehospitalised for AHF, while older men with dementia or high RDW are more prone to die without hospital readmission.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002167","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T11:16:13Z","timestamp":1679310973000},"page":"e002167","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["One-year rehospitalisation and mortality after acute heart failure hospitalisation: a competing risk analysis"],"prefix":"10.1136","volume":"10","author":[{"given":"Irene","family":"Marques","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Unidade Multidisciplinar de Investiga\u00e7\u00e3o Biom\u00e9dica (UMIB), Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal"},{"name":"ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal"}]},{"given":"Denisa","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal"},{"name":"Departamento de Estudos de Popula\u00e7\u00f5es, Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal"},{"name":"Unidade de Investiga\u00e7\u00e3o em Epidemiologia (EPIUnit), Instituto de Sa\u00fade P\u00fablica da Universidade do Porto (ISPUP), Porto, Portugal"}]},{"given":"Laetitia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Departamento de Estudos de Popula\u00e7\u00f5es, Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade (CINTESIS), Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"2025081710080257000_10.1.e002167.1","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2025081710080257000_10.1.e002167.2","first-page":"219","article-title":"Heart failure in the elderly","volume":"18","author":"D\u00edez-Villanueva","year":"2021","journal-title":"J Geriatr Cardiol"},{"key":"2025081710080257000_10.1.e002167.3","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.repc.2020.01.001","article-title":"Heart failure hospitalization: just a piece in the puzzle","volume":"38","author":"Andrade","year":"2019","journal-title":"Rev Port Cardiol (Engl Ed)"},{"key":"2025081710080257000_10.1.e002167.4","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.566"},{"key":"2025081710080257000_10.1.e002167.5","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.hlc.2015.04.168","article-title":"An absolute risk prediction model to determine unplanned cardiovascular readmissions for adults with chronic heart failure","volume":"24","author":"Betihavas","year":"2015","journal-title":"Heart Lung Circ"},{"key":"2025081710080257000_10.1.e002167.6","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1002\/ejhf.287","article-title":"A simple validated method for predicting the risk of hospitalization for worsening of heart failure in ambulatory patients: the redin-SCORE","volume":"17","author":"\u00c1lvarez-Garc\u00eda","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.7","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.785"},{"key":"2025081710080257000_10.1.e002167.8","doi-asserted-by":"crossref","first-page":"2526","DOI":"10.1111\/jocn.14830","article-title":"Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: a longitudinal observational study","volume":"28","author":"Ma","year":"2019","journal-title":"J Clin Nurs"},{"key":"2025081710080257000_10.1.e002167.9","doi-asserted-by":"crossref","first-page":"131","DOI":"10.36628\/ijhf.2020.0007","article-title":"Rate of rehospitalization in 60 days of discharge and it\u2019s determinants in patients with heart failure with reduced ejection fraction in a tertiary care centre in India","volume":"2","author":"Bhosale","year":"2020","journal-title":"Int J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.10","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1002\/ehf2.13221","article-title":"Hospital readmissions of patients with heart failure from real world: timing and associated risk factors","volume":"8","author":"Wideqvist","year":"2021","journal-title":"ESC Heart Fail"},{"key":"2025081710080257000_10.1.e002167.11","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jjcc.2018.07.009","article-title":"Risk prediction for 30-day heart failure-specific readmission or death after discharge: data from the korean acute heart failure (korahf) registry","volume":"73","author":"Lim","year":"2019","journal-title":"J Cardiol"},{"key":"2025081710080257000_10.1.e002167.12","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jclinepi.2020.03.004","article-title":"Ignoring competing events in the analysis of survival data may lead to biased results: a nonmathematical illustration of competing risk analysis","volume":"122","author":"Schuster","year":"2020","journal-title":"J Clin Epidemiol"},{"key":"2025081710080257000_10.1.e002167.13","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1002\/ejhf.1139","article-title":"Effect of sacubitril\/valsartan on recurrent events in the prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF)","volume":"20","author":"Mogensen","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.14","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-305294"},{"key":"2025081710080257000_10.1.e002167.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2011.03.017"},{"key":"2025081710080257000_10.1.e002167.16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.repc.2016.10.011","article-title":"Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: the PRECIC study","volume":"36","author":"Marques","year":"2017","journal-title":"Rev Port Cardiol"},{"key":"2025081710080257000_10.1.e002167.17","doi-asserted-by":"crossref","unstructured":"Irene Marques R-R , Mendon\u00e7a D , Teixeira L . One-year mortality after hospitalisation for acute heart failure: predicting factors (PRECIC study subanalysis) [IN PRESS]. Revista Portuguesa de Cardiologia 2022.","DOI":"10.1016\/j.repc.2022.07.017"},{"key":"2025081710080257000_10.1.e002167.18","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.115.001841"},{"key":"2025081710080257000_10.1.e002167.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.07.006"},{"key":"2025081710080257000_10.1.e002167.20","doi-asserted-by":"publisher","DOI":"10.1161\/HHF.0000000000000006"},{"key":"2025081710080257000_10.1.e002167.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.038"},{"key":"2025081710080257000_10.1.e002167.22","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1001\/jamacardio.2017.4265","article-title":"Association of the hospital readmissions reduction program implementation with readmission and mortality outcomes in heart failure","volume":"3","author":"Gupta","year":"2018","journal-title":"JAMA Cardiol"},{"key":"2025081710080257000_10.1.e002167.23","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1002\/ehf2.12687","article-title":"Age-Related longitudinal change in cardiac structure and function in adults at increased cardiovascular risk","volume":"7","author":"Gong","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2025081710080257000_10.1.e002167.24","unstructured":"National Guideline C . National institute for health and care excellence: guidelines. In: Chronic Heart Failure in Adults: Diagnosis and Management. London: National Institute for Health and Care Excellence (NICE), 2018."},{"key":"2025081710080257000_10.1.e002167.25","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"2025081710080257000_10.1.e002167.26","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/ejhf.890","article-title":"Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC heart failure long-term registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.01.041"},{"key":"2025081710080257000_10.1.e002167.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.04.006"},{"key":"2025081710080257000_10.1.e002167.29","doi-asserted-by":"publisher","DOI":"10.5414\/CN107961"},{"key":"2025081710080257000_10.1.e002167.30","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1002\/ejhf.2219","article-title":"Association between up-titration of medical therapy and total hospitalizations and mortality in patients with recent worsening heart failure across the ejection fraction spectrum","volume":"23","author":"Bistola","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.31","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1002\/ejhf.2103","article-title":"Temporal trends in mortality and readmission after acute heart failure: a systematic review and meta-regression in the past four decades","volume":"23","author":"Kimmoun","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.32","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/ejhf.1615","article-title":"Association between beta-blocker use and mortality\/morbidity in older patients with heart failure with reduced ejection fraction. A propensity score-matched analysis from the Swedish heart failure registry","volume":"22","author":"Stolfo","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2017.04.007"},{"key":"2025081710080257000_10.1.e002167.34","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/ejhf.631","article-title":"Heart failure and risk of dementia: a Danish nationwide population-based cohort study","volume":"19","author":"Adelborg","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2025081710080257000_10.1.e002167.35","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s11739-018-1958-z","article-title":"Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in acute heart failure (RE-AHF) study","volume":"14","author":"Melchio","year":"2019","journal-title":"Intern Emerg Med"},{"key":"2025081710080257000_10.1.e002167.36","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0244608","article-title":"Association between platelet distribution width and prognosis in patients with heart failure","volume":"15","author":"Sato","year":"2020","journal-title":"PLoS One"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2022-002167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:08:14Z","timestamp":1755450494000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2022-002167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,20]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/openhrt-2022-002167"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2022-002167","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}