The Antecedents of Heart Failure Patient Readmissions; A Systematic Review

Abstract

This review synthesizes evidence on antecedents of hospital readmission after heart failure (HF) hospitalization. Reported risk markers cannot be treated as equivalent findings when outcomes, case-mix, follow-up and competing death differ; therefore, the present synthesis examines 47 distinct primary publications from 2015-2025 using a PRISMA-informed narrative approach. The evidence covers administrative and clinical cohorts, direct functional assessment and intervention research. Comorbidity, renal impairment, congestion, psychological vulnerability, social conditions and continuity of care recur as investigated domains. However, a nationwide risk model produced weak discrimination despite a very large sample, while a smaller clinical cohort found that conventional comorbidities alone classified future return poorly. Direct physical-function testing and biomarker information may provide complementary prognostic information but require external validation. Findings for post-discharge follow-up differ when outcomes are HF hospitalization rather than mortality or a composite endpoint. Domain frequencies describe research coverage, not effect size, consistency or causality. The screening process is summarized in a PRISMA flow diagram, while differences in study design and outcome definitions favor narrative synthesis over a pooled estimate.