National Trends in Admission and In‐Hospital Mortality of Patients With Heart Failure in the United States (2001–2014)

Akintoye, Emmanuel; Briasoulis, Αlexandros; Egbe, Alexander C.; Dunlay, Shannon M.; Kushwaha, Sudhir S.; Levine, Diane; Afonso, Luís; Mozaffarian, Dariush; Weinberger, Jarrett

doi:10.1161/jaha.117.006955

Cited by 93 publications

(57 citation statements)

References 18 publications

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“…Our admission age (64 yrs) is relatively lower compared to high income countries such as the U.S. (73 years) and Western Europe (72 years) as expected, but is in line with other upper middle income countries like Jamaica and Brazil and higher than most countries in Africa and Asia. 32 , 33 , 34 , 35 , 36 , 37 The Hindustani sub-cohort was more frequently admitted for HF admissions, followed by Creole and Javanese which differs slightly from the size of the three largest ethnic groups in Suriname, respectively Hindustani, Tribal communities and Creole. 20 This difference may be partly explained by the differential access of care since the AZP is situated in the capital and people from the rural regions, specifically Tribal and Indigenous communities, may have difficulty accessing AZP health services.…”

Section: Resultsmentioning

confidence: 96%

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Sairras

Baldew

Hilst

et al. 2021

Journal of the National Medical Association

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Introduction Heart failure (HF) is an emerging epidemic with poor disease outcomes and differences in its prevalence, etiology and management between and within world regions. Hypertension (HT) and ischemic heart disease (IHD) are the leading causes of HF. In Suriname, South-America, data on HF burden are lacking. The aim of this Suriname Heart Failure I (SUHF–I) study, is to assess baseline characteristics of HF admitted patients in order to set up the prospective interventional SUHF-II study to longitudinally determine the effectiveness of a comprehensive HF management program in HF patients. Methods A cross-sectional analysis was conducted of Thorax Center Paramaribo (TCP) discharge data from January 2013-December 2015. The analysis included all admissions with primary or secondary discharge of HF ICD-10 codes I50-I50.9 and I11.0 and the following variables: patient demographics (age, sex, and ethnicity), # of readmissions, risk factors (RF) for HF: HT, diabetes mellitus (DM), smoking, and left ventricle (LV) function. T-tests were used to analyze continuous variables and Chi-square test for categorical variables. Differences were considered statistically significant when a p-value <0.05 is obtained. Results 895 patients (1:1 sex ratio) with either a primary (80%) or secondary HF diagnosis were admitted. Female patients were significantly older (66.2 ± 14.8 years, p < 0.01) at first admission compared to male patients (63.5 ± 13.7 years) and the majority of admissions were of Hindustani and Creole descent. HT, DM and smoking were highly prevalent respectively 62.6%, 38.9 and 17.3%. There were 379 readmissions (29.1%) and 7% of all admissions were readmissions within 30 days and 16% were readmissions for 31-365 day. IHD is more prevalent in patients from Asian descendant (52.2%) compared to African descendant (11.7%). Whereas, HT (39.3%) is more prevalent in African descendants compared to Asian descendants (12.7%). There were no statistically significant differences in age, sex, ethnicity, LV function and RFs between single admitted and readmitted patients. Conclusion RF prevalence, ethnic differences and readmission rates in Surinamese HF patients are in line with reports from other Caribbean and Latin American countries. These results are the basis for the SUHF-II study which will aid in identifying the country specific and clinical factors for the successful development of a multidisciplinary HF management program.

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Section: Resultsmentioning

confidence: 96%

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Sairras

Baldew

Hilst

et al. 2021

Journal of the National Medical Association

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“…Although the reason for the decline in in‐hospital mortality rates can be partly related to the decrease in LOHS, as shown in a cohort study, 30‐day mortality was unchanged in this study and thus such effects might be small. From the nation‐wide data in the United States, the rate of in‐hospital mortality among patients hospitalized with HF declined consistently between 2001 and 2014 16. More specifically, the decline was observed from 2005 onward.…”

Section: Discussionmentioning

confidence: 99%

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

Shiraishi

Kohsaka

Sato

et al. 2018

JAHA

175

111

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BackgroundAcute heart failure (AHF) is a heterogeneous condition, and its characteristics and management patterns differ by region. Furthermore, limited evidence is available on AHF outside of Western countries. A project by the National Consortium of Acute Heart Failure Registries was designed to evaluate the trends over time in patient backgrounds, in‐hospital management patterns, and long‐term outcomes of patients with AHF over 9 years in Japan.Methods and ResultsBetween 2007 and 2015, registry data for patients with AHF were collected from 3 large‐scale quality AHF registries (ATTEND/WET‐HF/REALITY‐AHF). Predefined end points were trends over time in age, sex, and clinical outcomes, including short‐ and long‐term mortality and readmission for heart failure. The final data set consisted of 9075 patients with AHF. No significant differences in patient backgrounds and laboratory findings (eg, anemia or renal function) were observed, with the exception of patient age; mean age became substantially higher over 9 years (71.6–77.0 years; P for trend, <0.001). On the contrary, length of hospital stay became shorter (mean, 26–16 days). These changes were not associated with in‐hospital mortality (4.7–7.5%) or 30‐day heart failure readmission rate (4.8–5.4%), as well as 1‐year mortality and heart failure readmission rate (20.1–23.3% and 23.6–26.2%, respectively).ConclusionsLength of hospital stay in patients with AHF shortened over the 9‐year period despite the increasing age of the patients. However, short‐ and long‐term outcomes do not seem to be affected; continuous efforts to monitor clinical outcomes in patients with AHF are needed.

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“…The NIS does not allow for ascertainment of cause-specific mortality in our study. Although overall in-hospital mortality in AHF hospitalization is declining,42 our results suggest that mortality has not declined among both HFPEF and HFREF patients who require respiratory support. Thus, these populations represent important groups to target future research, specialty expertise, and programmatic resources.4.3 | Factors associated with respiratory support in HFPEF and HFREFPulmonary disease was mildly associated with IMV use in both populations, however by far the strongest predictor of need for IMV was cardiac complications of cardiac arrest and cardiogenic shock, irrespective of LVEF.…”

mentioning

confidence: 56%

“…The NIS does not allow for ascertainment of cause‐specific mortality in our study. Although overall in‐hospital mortality in AHF hospitalization is declining, our results suggest that mortality has not declined among both HFPEF and HFREF patients who require respiratory support. Thus, these populations represent important groups to target future research, specialty expertise, and programmatic resources.…”

Section: Discussionmentioning

confidence: 99%

Respiratory support in acute heart failure with preserved vs reduced ejection fraction

Metkus

Stephens

Schulman

et al. 2019

Clinical Cardiology

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Background There is little evidence addressing the use and differential impact of respiratory support in acute heart failure (AHF) patients with preserved (HFPEF) vs reduced (HFREF) ejection fraction. Therefore, our objective was to determine the usage and clinical outcomes of critical care respiratory support in AHF across the two populations. Hypothesis Respiratory support would be associated with adverse outcome in both HFPEF and HFREF. Methods We identified HFPEF, HFREF, invasive mechanical ventilation (IMV), and noninvasive ventilation (NIV) using International Classification of Disease‐Ninth Edition codes in the National Inpatient Sample between January 1, 2008 and December 31, 2014. We determined rates of IMV and NIV use. We identified predictors of need for IMV and NIV and the association between ventilation strategies and in‐hospital mortality in HFPEF vs HFREF. Results 1.3 million AHF‐HFPEF and 1.7 million AHF‐HFREF hospitalizations were included; 5.98% of AHF HFPEF hospitalizations included NIV and 0.57% included IMV. Among HFREF hospitalizations, fewer (4.1%) included NIV and more (0.93%) included IMV. In HFPEF hospitalization, NIV use was associated with 2.24‐fold increased risk for death compared to no respiratory support in an adjusted model (HR 2.24 95% CI 2.05‐2.44) and IMV use was associated with 2.85‐fold increased risk for death (HR 2.85 95% CI 2.30‐3.53). This increased risk of in‐hospital mortality was similar among HFREF patients. Conclusions Use of respiratory support is increasing among patients with both HFPEF and HFREF and associated with substantially increased mortality in both heart failure subtypes.

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National Trends in Admission and In‐Hospital Mortality of Patients With Heart Failure in the United States (2001–2014)

Cited by 93 publications

References 18 publications

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

Respiratory support in acute heart failure with preserved vs reduced ejection fraction

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