This study aimed to identify the factors influencing multiple admissions within 1 year for patients with heart failure (HF) and to examine the impact of early readmission on subsequent admissions. A retrospective questionnaire survey was conducted on 498 patients with HF admitted to our hospital's Cardiology department between January 1, 2020, and December 31, 2022. Multivariate regression analysis identified factors influencing multiple admissions, and propensity score matching (PSM) assessed the impact of readmissions within 30 days and 31 to 90 days post-discharge on unplanned admissions within a year. The incidence of multiple admissions was 22.09% (110/498), with first readmissions within 30 days post-discharge at 13.25% (66/498) and within 31 to 90 days at 15.86% (79/498). Influential factors for multiple unplanned hospital admissions included age, history of atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, New York Heart Association grade ≥ III, hemoglobin (Hb) <
110g/L, taking 7 or more medications, and readmission within 31 to 90 days (P <
.05). Post-PSM analysis showed that the first admission within 30 days (odds ratio [OR] = 6.400, 95% confidence interval [Cl] = 2.638-15.527, P = .001), and the first admission within 31 to 90 days significantly increased the risk of multiple admissions (OR = 5.694, 95% Cl = 2.615-12.402, P = .001). Patients with HF exhibit a high rate of numerous readmissions within 1 year. Clinical medical staff should focus more on patients with early readmissions, enhance self-management, and improve management of comorbidities and medications through a multidisciplinary team approach. Enhancing continuous nursing and improving access to medical services may reduce patient readmission rates.