Burden of hospitalizations in newly diagnosed heart failure patients in Poland: real world population based study in years 2013–2019

Abstract

AimsWe aim to report trends in unplanned hospitalizations among newly diagnosed heart failure patients with regard to hospitalizations types and their impact on outcomes. Methods and resultsA nation-wide study of all citizens in Poland with newly diagnosed heart failure based on ICD-10 coding who were beneficiaries of either public primary, secondary, or hospital care between 2013 and 2018 in Poland. Between 1 January 2013 and 31 December 2019, there were 1 124 118 newly diagnosed heart failure patients in Poland in both out-and inpatient settings. The median observation time was 946 days. As many as 49% experienced at least one acute heart failure hospitalization. Once hospitalized, 44.6% patients experienced at least one all-cause rehospitalization and 26% another heart failure rehospitalization. The latter had the highest Charlson co-morbidity index (1.36). The 30 day heart failure readmission rate was 2.96%. Kaplan-Meier analysis revealed very early readmissions (up to 1-7 days) were associated with better survival compared with rehospitalization between 8 and 30 days. All-cause mortality was related to the number of hospitalization with adjusted estimated hazard ratios: 1.550 (95% CI: 1.52-158) for the second HF hospitalization, 2.158 (95% CI: 2.098-2.219) for third, and 2.788 (95% CI: 2.67-2.91) for the fourth HF hospitalization and subsequent ones, as compared with the first hospitalization. Conclusions Among newly diagnosed heart failure patients in Poland between 2013 and 2019, nearly half required at least one unplanned heart failure hospitalization. The risk of death was growing with every other hospital reoccurrence due to heart failure.

Long-term prognostic scores may underestimate the risk of death in patients with heart failure with reduced ejection fraction in whom red cells distribution width is elevated

“…17,18 This universality may be the most important in the patients with chronic HFrEF, because a large proportion of the risk in these patients comes from multimorbidity, as clearly documented in a large number of previous research. 39 A recent epidemiologic study in almost 1 million of people living in Sweden presents chronic HFrEF in the wider context of coexisting chronic diseases. In this perspective, chronic HFrEF should not be regarded as a central pathology with other diseases as unpleasant companions, but rather as a component of high -risk clinical state, 40 in which prognostication should rely on markers capturing the risk from as many recognized sources as possible.…”

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“…But still, we may not ignore the huge number of HF patients in the community. After all, hospitalized HF patients only account for about one-third of the total number of HF patients ( 33 ). Therefore, ADL impairment in HF patients should be taken into consideration by community health workers.…”

Assessment of adherence to treatment recommendations among patients with heart failure: a cross-sectional study

“…HF is a leading cause of hospitalization for individuals aged 65 and older in Poland, with nearly 180,000 admissions annually and more than half requiring rehospitalization. Additionally, one in four patients undergoes inpatient treatment within 30 days of discharge [ 7 , 8 ]. Despite advancements in cardiovascular disease treatment, the annual mortality rate from HF remains high, with approximately 140,000 HF-related deaths reported in Poland in 2018, representing over 30% of all deaths during that period [ 8 ].…”