Mortality and readmissions in heart failure: an analysis of 36,824 elderly patients from the Slovenian national hospitalization database

Omersa, Daniel; Lainščak, Mitja; Eržen, Ivan; Farkaš, Jerneja

doi:10.1007/s00508-016-1098-2

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…Health systems are known to differ in patient characteristics and factors such as access to care and funding models, which may impact the observed frequency of HF outcomes and the extent of variation among hospitals 7 . However, national studies of outcomes following HF hospitalisations outside the US are sparse 8–11 and recent trends in these outcomes are uncertain. Moreover, to our knowledge, no national study has systematically examined institutional variation in HF 30‐day mortality or readmission rates beyond the US population.…”

Section: Introductionmentioning

confidence: 99%

Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand

Labrosciano

Horton

Air

et al. 2020

European J of Heart Fail

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Aims National 30‐day mortality and readmission rates after heart failure (HF) hospitalisations are a focus of US policy intervention and yet have rarely been assessed in other comparable countries. We examined the frequency, trends and institutional variation in 30‐day mortality and unplanned readmission rates after HF hospitalisations in Australia and New Zealand. Methods and results We included patients >18 years hospitalised with HF at all public and most private hospitals from 2010–15. The primary outcomes were the frequencies of 30‐day mortality and unplanned readmissions, and the institutional risk‐standardised mortality rate (RSMR) and readmission rate (RSRR) evaluated using separate cohorts. The mortality cohort included 153 592 patients (mean age 78.9 ± 11.8 years, 51.5% male) with 16 442 (10.7%) deaths within 30 days. The readmission cohort included 148 704 patients (mean age 78.6 ± 11.9 years, 51.7% male) with 33 158 (22.3%) unplanned readmission within 30 days. In 392 hospitals with at least 25 HF hospitalisations, the median RSMR was 10.7% (range 6.1–17.3%) with 59 hospitals significantly different from the national average. Similarly, in 391 hospitals with at least 25 HF hospitalisations, the median RSRR was 22.3% (range 17.7–27.1%) with 24 hospitals significantly different from the average. From 2010–15, the adjusted 30‐day mortality [odds ratio (OR) 0.991/month, 95% confidence interval (CI) 0.990–0.992, P < 0.01] and unplanned readmission (OR 0.998/month, 95% CI 0.998–0.999, P < 0.01) rates declined. Conclusion Within 30 days of a HF hospitalisation, one in 10 patients died and almost a quarter of those surviving experienced an unplanned readmission. The risk of these outcomes varied widely among hospitals suggesting disparities in HF care quality. Nevertheless, a substantial decline in 30‐day mortality and a modest decline in readmissions occurred over the study period.

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Section: Introductionmentioning

confidence: 99%

Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand

Labrosciano

Horton

Air

et al. 2020

European J of Heart Fail

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“…However, the mean life expectancy has been extended worldwide, and applying this age category definition to compare differences among age groups is not always appropriate, especially in developed counties with a longer life expectancy. For example, some gerontology studies divided elderly people into two age categories, young-old people and old-old people, and showed differences regarding health effects [53,54]. In our study, the risks of 60–79 years and ≥80 years tended to be different.…”

Section: Discussionmentioning

confidence: 50%

Effects of high ambient temperature on ambulance dispatches in different age groups in Fukuoka, Japan

Kotani

Ueda

Seposo

et al. 2018

Global Health Action

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Background: The elderly population has been the primary target of intervention to prevent heat-related illnesses. According to the literature, the highest risks have been observed among the elderly in the temperature–mortality relationship. However, findings regarding the temperature–morbidity relationship are inconsistent. Objectives: This study aimed to examine the association of temperature with ambulance dispatches due to acute illnesses, stratified by age group. Specifically, we explored the optimum temperature, at which the relative health risks were found to be the lowest, and quantified the health risk associated with higher temperatures among different age groups. Methods: We used the data for ambulance dispatches in Fukuoka, Japan, during May and September from 2005 to 2012. The data were grouped according to age in 20-year increments. We explored the pattern of the association of ambulance dispatches with temperature using a smoothing spline curve to identify the optimum temperature for each age group. Then, we applied a distributed lag nonlinear model to estimate the risks of the 85th–95th percentile temperature relative to the overall optimum temperature, for each age group. Results: The relative risk of ambulance dispatches at the 85th and 95th percentile temperature for all ages was 1.08 [95% confidence interval (CI): 1.05, 1.12] and 1.12 (95% CI: 1.08, 1.16), respectively. In comparison, among age groups, the optimum temperature was observed as 25.0°C, 23.2°C, and 25.3°C for those aged 0–19, 60–79, and ≥80, respectively. The optimum temperature could not be determined for those aged 20–39 and 40–59. The relative risks of high temperature tended to be higher for those aged 20–39 and 40–59 than those for other age groups. Conclusions: We did not find any definite difference in the effect of high temperature on ambulance dispatches for different age groups. However, more measures should be taken for younger and middle-aged people to avoid heat-related illnesses.

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“…Collection of the data and HF hospitalization definitions were reported previously . In brief, we documented hospital stay, hospital identificator, sex, age, co‐morbidities, statistical region of permanent residence, and date of death of all patients' HF hospitalizations.…”

Section: Methodsmentioning

confidence: 99%

Regional differences in heart failure hospitalizations, mortality, and readmissions in Slovenia 2004–2012

et al. 2019

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AimsHeart failure (HF) burden is displaying significant inter‐regional differences within Europe and within countries. Due to limited data focusing on regional differences, our aim was to evaluate HF hospitalizations, readmissions, and mortality burden in Slovenian statistical regions.Methods and resultsThe Slovenian National Hospitalization Discharge Registry was searched for HF hospitalizations in patients 20 years or over in the period 2004–12. Annual sex and age‐standardized HF hospitalizations, mortality, and HF readmissions rates were calculated for Slovenia and for each Slovenian statistical region. Trends were evaluated using ANOVA. Multiple mixed effect logistic regression models, which included statistical region, admission year, sex, age, intensive care unit treatment, and co‐morbidities as a fixed effect and hospital identifier as a random effect, were calculated for mortality and readmissions. Overall, 156 859 HF hospitalizations (55 522 where HF was coded as a main diagnosis and 43 606 as first HF hospitalizations) were recorded. Annual standardized rates varied considerably between statistical regions for main (220–511) and first HF hospitalization (392–721), 30 day (12.6–27.1) and 1 year mortality (66–117), and 30 day (31–80.8) and 1 year readmission (99–24) (per 100 000 patient years in 2012). Yearly decline in HF hospitalization rates was seen for national main (3.6; 0.001) and first (8.4; 0.083) HF hospitalizations, while individual regional main and first HF hospitalization trends mostly did not reach statistical significance. No relevant differences in mortality and readmission endpoints for statistical regions were seen when adjusted for patient demographics and specific co‐morbidities.ConclusionsSignificant regional differences in standardized HF hospitalization, mortality, and readmissions between the regions were seen. There were no differences in mortality and readmissions between statistical regions for individual similar patients.

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Mortality and readmissions in heart failure: an analysis of 36,824 elderly patients from the Slovenian national hospitalization database

Abstract: Age is an independent predictor of mortality but not readmissions in elderly patients with first HF hospitalization. Comorbidities are important predictors for mortality and readmissions in elderly.

Cited by 13 publications

References 28 publications

Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand

Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand

Effects of high ambient temperature on ambulance dispatches in different age groups in Fukuoka, Japan

Regional differences in heart failure hospitalizations, mortality, and readmissions in Slovenia 2004–2012

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