OBJECTIVE: This study aims to investigate the prognostic impact of the presence and type of prior hospitalizations in patients with heart failure with mildly reduced ejection fraction (HFmrEF). BACKGROUND: Data investigating the prognostic impact of the present and type of previous all-cause hospitalizations in HFmrEF is limited. METHODS: Consecutive patients hospitalized with HFmrEF at a single medical center were retrospectively included from 2016 to 2022. The prognosis of patients with a prior hospitalization <
12 months was compared to patients without. The primary endpoint was all-cause mortality at 30 months (median follow-up), the key secondary endpoint was heart failure (HF)-related rehospitalization at 30 months. RESULTS: Two thousand one hundred eighty four patients with HFmrEF were included, 34.8% had a previous hospitalization <
12 months (admission to internal medicine and geriatrics: 60.8%, surgical department: 23.5%). The presence of a previous hospitalization was associated with an increased risk of all-cause mortality (38.6% vs. 27.4%
HR = 1.51
95% CI 1.30-1.76
p = 0.01) and HF-related rehospitalization at 30 months (21.2% vs. 9.1%
HR = 2.48
95% CI 1.96-3.14
p = 0.01), even after multivariable adjustments. However, the department of previous hospitalization (internal medicine vs. surgical) did not significantly affect the risk of 30-months all-cause mortality (37.1% vs. 43.2%
HR = 0.82, 95% CI 0.63-1.08
p = 0.16) or HF-related rehospitalization (24.0% vs. 16.8%
HR = 1.47, 95% CI 0.98-2.24
p = 0.07). Finally, the type of previous admission (i.e., elective, emergency vs. HF-related admission) (log-rank p = 0.29) did not affect the risk of 30-months all-cause mortality. CONCLUSION: Prior hospitalizations within 12 months were independently associated with impaired long-term mortality in patients with HFmrEF, irrespective of the department or type of prior admission.