Thirty‐year trends in heart failure hospitalization and mortality rates and the prognostic impact of co‐morbidity: a Danish nationwide cohort study

Abstract

AimsWe examined 30-year nationwide trends in heart failure hospitalization and mortality rates, and the prognostic impact of co-morbidity. Methods and resultsWe conducted a population-based cohort study of 317 161 patients with first-time inpatient hospitalizations for heart failure during 1983-2012. We computed the standardized hospitalization rate and 5-year mortality risk. Co-morbidity levels and calendar periods of diagnosis were compared by means of mortality rate ratios (MRRs) based on Cox regression. The standardized hospitalization rate (per 100 000 persons) decreased between 1983 and 2012 by 25% for women (from 192 to 144) and by 14% for men (from 217 to 186). The decrease reflected an average annual 1% increase until 2000 and a 3.5% decline thereafter. Between 1983Between -1987Between and 2008Between -2012, 1-year mortality declined from 45% to 33% and 1-to 5-year mortality from 59% to 43%. The decline occurred independently of patients' co-morbidity levels. Comparing 2008Comparing -2012Comparing with 1983Comparing -1987, the 5-year age-, sex-, and co-morbidity-adjusted MRR was 0.57 [95% confidence interval (CI) 0.56-0.58]. Using low co-morbidity as reference, the adjusted 5-year MRR in 2003-2007 was increased by 43% for moderate, 66% for severe, and 2.2-fold for very severe co-morbidity. The magnitude of co-morbidity-associated mortality increased over time and was highest in the youngest patients.

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

“…The improvement of in‐hospital mortality might have resulted from the American College of Cardiology/American Heart Association guidelines updated in 2005, which included more‐robust evidence from clinical trials. The data from a Danish nation‐wide cohort study also showed that mortality rates declined consistently from 1983 to 2012, and its reduction was independent of age, sex, and comorbidity burden 17. These changes might have affected the results of our current study.…”

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

“…Advances in both the medical and device based treatments, have been associated with improved survival rates in patients with HF in many [17][18][19][20] but not all national registry-based studies. 21 Age-standardized death rates from heart failure have been reported to decrease by 40% in seven European countries between 1987 and 2008.…”

Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study

“…[1][2][3][4] Still, cardiovascular diseases remain a leading cause of death worldwide, 5 underscoring the need for further research. Registries constitute an important source of data for cardiovascular research in Denmark.…”