{"id":"5ab6489b60c3","type":"article","url":"https://hartvaat.nl/2026/08/20/risicofactoren-voor-vroege-tussen-en-late-hartfalenheropnames-na-ontslag/","title":"Risicofactoren voor vroege, tussen- en late hartfalenheropnames na ontslag","title_en":"Timing-Specific Factors Associated With Early, Intermediate, and Late Readmission After Heart Failure Hospitalisation.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag219","source_url":"https://doi.org/10.1093/eschf/xvag219","authors":["Gen Li","Zhanyue Shi","Tengfei Gu","Guanghui Li","Ziniu Zhao","Lili Shi"],"significance":4,"published":"2026-08-28","source_date":"2026-08-20","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/bloedsuikerdoelen-cardiovasculair/","https://hartvaat.nl/kennis/nierziekte/contrastmiddel-en-nierfunctie/"],"congress":"","summary_en":"This secondary analysis of 1,992 patients discharged from a single-centre heart failure cohort identified distinct risk factors for readmissions within 180 days. Early readmissions (≤28 days) were linked to advanced heart failure severity, reduced eGFR, and hyponatraemia, whereas late readmissions (91-180 days) showed stronger associations with dementia, chronic kidney disease, and diabetes. Predictive models showed modest discrimination (AUC 0.63–0.68). The findings suggest that post-discharge follow-up strategies should be tailored to the specific time window and the patient’s comorbidity profile.","created":"2026-08-21T01:38:31Z","updated":"2026-08-21T01:38:31Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een secundaire analyse van 1.992 patiënten met hartfalen werden risicofactoren voor heropnames binnen 180 dagen na ontslag onderzocht. Vroege heropnames (≤28 dagen) hingen samen met ernstige hartfalenklachten, nierfunctievermindering en hyponatraemie, terwijl late heropnames (91-180 dagen) sterker geassocieerd waren met dementie, chronische nierziekte en diabetes. De voorspellende waarde van de modellen was matig (AUC 0,63–0,68). Deze bevindingen benadrukken dat de opvolging na een hartfalenziekenhuisopname op maat gemaakt moet worden op basis van het tijdstip en de onderliggende comorbiditeit.","abstract_original":"AIMS: To identify factors associated with early, intermediate, and late readmission after heart failure hospitalisation. METHODS AND RESULTS: This secondary analysis included 1,992 patients discharged alive from a single-centre Chinese heart failure cohort. Median age was 75 years (interquartile range 65-85), and 58.2% were female. Within 6 months, 776 patients (39.0%) were readmitted: 140 (7.0%) early (≤28 days), 358 (18.0%) intermediate (29-90 days), and 278 (14.0%) late (91-180 days). Early readmission was associated with biventricular heart failure (odds ratio 1.72; P = 0.022), New York Heart Association class IV (1.47; P = 0.043), estimated glomerular filtration rate <60 mL/min/1.73 m2 (1.64; P = 0.021), and hyponatraemia (1.71; P = 0.008). Intermediate readmission was associated with biventricular heart failure (1.68; P < 0.001), systolic blood pressure <110 mmHg (1.68; P < 0.001), and B-type natriuretic peptide ≥1,000 pg/mL (1.32; P = 0.029). Late readmission was associated with dementia (2.30; P < 0.001), biventricular heart failure (1.69; P = 0.002), chronic kidney disease (1.56; P = 0.030), and diabetes (1.44; P = 0.043). Apparent areas under the curve were 0.677, 0.641, and 0.629 for early, intermediate, and late readmission, respectively. CONCLUSIONS: Associated factors differed across post-discharge intervals but overlapped. Early readmission was associated with advanced heart failure severity and cardiorenal-electrolyte instability. Intermediate readmission was associated with haemodynamic compromise and cardiac stress. Late readmission demonstrated stronger associations with chronic comorbidity burden, alongside cognitive and systemic disease. Biventricular heart failure was associated with all three intervals. These findings require external validation."}