Heart failure in Norway, 2000–2014: analysing incident, total and readmission rates using data from the Cardiovascular Disease in Norway (CVDNOR) Project

Abstract

Aims To examine trends in heart failure (HF) hospitalization rates and risk of readmissions following an incident HF hospitalization. Methods and results During 2000–2014, we identified in the Cardiovascular Disease in Norway Project 142 109 hospitalizations with HF as primary diagnosis. Trends of incident and total (incident and recurrent) HF hospitalization rates were analysed using negative binomial regression models. Changes over time in 30‐day and 3‐year risk of HF recurrences or cardiovascular disease (CVD)‐related readmissions were analysed using Fine and Grey competing risk regression, with death as competing events. Age‐standardized rates declined on average 1.9% per year in men and 1.8% per year in women for incident HF hospitalizations (both Ptrend < 0.001) but did not change significantly in either men or women for total HF hospitalizations. In men surviving the incident HF hospitalization, 30‐day and 3‐year risk of a HF recurrent event increased 1.7% and 1.2% per year, respectively. Similarly, 30‐day and 3‐year risk of a CVD‐related hospitalization increased 1.5% and 1.0% per year, respectively (all Ptrend < 0.001). No statistically significant changes in the risk of HF recurrences or CVD‐related readmissions were observed among women. In‐hospital mortality for a first and recurrent HF episode declined over time in both men and women. Conclusions Incident HF hospitalization rates declined in Norway during 2000–2014. An increase in the risk of recurrences in the context of reduced in‐hospital mortality following an incident and recurrent HF hospitalization led to flat trends of total HF hospitalization rates.

The year in cardiovascular medicine 2020: heart failure and cardiomyopathies

“…Significant regional differences in the management of acute HF have been identified, including timing and types nja, 8 učestalosti i vremenskih trendova ponovnih prijema. 2,9,10 Ipak, naglašena je važnost razlikovanja između pogoršanja kroničnog od novonastalog oblika HF-a u bolesnika u prvoj hospitalizaciji, jer bolesnici s pogoršanjem/kroničnim HFom imaju mnogo veće opterećenje komorbiditetima i veći prilagođeni rizik mortaliteta i hospitalizacije zbog HF-a. 10,11 Klinička obilježja diJAGNOsTikA i sTRATifikAciJA RizikA…”

February 2020 at a glance: acute heart failure and cardio‐oncology

“…Hospitalizations for acute heart failure (AHF) are associated with poor outcomes . Sulo et al . examined trends in heart failure (HF) hospitalization rates in Norway.…”

The recurring problem of heart failure hospitalisations

“…In this issue of the Journal, Sulo et al 7 present an analysis of incident and total hospitalisations for heart failure in Norway between 2000 and 2014. The data from this nationwide retrospective cohort study (which contains all hospital stays with a cardiovascular-related diagnosis) confirm that there has been a continual decline in the incidence of first hospitalisation for HF.…”

“…A consistent finding from HF registries around the world is the underuse of guideline-recommended therapies for HF. 12 Finally, it may be a methodological issue with the database used by Sulo et al 7 They were unable to differentiate HFrEF from HF with preserved ejection fraction (HFpEF). No therapies have yet been shown to be effective in HFpEF.…”

“…In this issue of the Journal, Sulo et al . present an analysis of incident and total hospitalisations for heart failure in Norway between 2000 and 2014.…”