Temporal trends in hospitalization and in-hospital mortality rates due to heart failure by age and sex in Spain (2003-2018)

2021 ◽  
Author(s):  
Manuel Anguita Sánchez ◽  
Juan Luis Bonilla Palomas ◽  
María García Márquez ◽  
José Luis Bernal Sobrino ◽  
Francisco Javier Elola Somoza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Age And Sex

Abstract 17132: Atrial Fibrillation Ablation in Heart Failure: Temporal Trends and Outcomes in Hospitalized Patients

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Manyoo Agarwal ◽  
Brijesh Patel ◽  
Lohit Garg ◽  
Mahek Shah ◽  
Rami Khouzam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Temporal Trends ◽  
Complication Rates ◽  
Af Ablation ◽  
Southern Us ◽  
Comorbidity Burden

Introduction: Recent studies have shown catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) to have better outcomes over medical therapy. While AF ablation is predominantly an outpatient procedure, some patients may require longer hospitalization. Limited literature exists describing the trends of hospitalizations for HF patients undergoing AF ablation. Methods: Using ICD-9 (diagnosis and procedure codes) in nationwide inpatient sample database 2003 to 2014, we identified all HF adults who were admitted with a principal diagnosis code of AF (427.31) (n= 4,670,400) (AF-HF). Among these, we identified those with a principal procedure code of catheter ablation (37.34) and studied the temporal trends of clinical characteristics and outcomes (in-hospital mortality and complications) for this cohort (Table). Results: The overall number of AF-HF patients undergoing AF ablation was 62,653; with an increase from 1,928 in 2003 to 6,860 in 2014 (p trend<0.001). As shown in Table, over this 12-year period; mean age and proportion of females decreased, while there was an increase in blacks, clinical comorbidity burden, admissions to teaching hospitals and southern US region (all p trend<0.001). The overall procedure related complications (vascular, cardiac, respiratory, neurologic) increased, the in-hospital mortality rate decreased from 1.7% to 0.5% (all p trend<0.001). Conclusions: During 2003-2014, the annual incidence of AF ablation related hospitalizations in HF patients increased significantly. Despite increase in clinical comorbidities burden and procedural complication rates, the mortality rate declined.

Mortality rates are going down in clinical use of inotropics. Temporal trends for prognosis in acute decompensated heart failure (1992/1999–2005/ 2006)

2014 ◽  
Vol 175 (3) ◽  
pp. 584-586 ◽  
Author(s):  
Juliano N. Cardoso ◽  
André Grossi ◽  
Carlos H. Del Carlo ◽  
Cristina Martins dos Reis ◽  
Milena Curiati ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Temporal Trends ◽  
Decompensated Heart Failure ◽  
Mortality Rates ◽  
Clinical Use

scholarly journals Temporal Trends in Sepsis Incidence and Mortality in Patients With Cancer in the US Population

2021 ◽  
Vol 30 (4) ◽  
pp. e71-e79
Author(s):  
Michael A. Liu ◽  
Brianna R. Bakow ◽  
Tzu-Chun Hsu ◽  
Jia-Yu Chen ◽  
Ke-Ying Su ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Hazard Ratio ◽  
Patients With Cancer ◽  
Incidence And Mortality ◽  
The Impact

Background Few population-based studies assess the impact of cancer on sepsis incidence and mortality. Objectives To evaluate epidemiological trends of sepsis in patients with cancer. Methods This retrospective cohort study included adults (≥20 years old) identified using sepsis-indicator International Classification of Diseases codes from the Nationwide Inpatient Sample database (2006-2014). A generalized linear model was used to trend incidence and mortality. Outcomes in patients with cancer and patients without cancer were compared using propensity score matching. Cox regression modeling was used to calculate hazard ratios for mortality rates. Results The study included 13 996 374 patients, 13.6% of whom had cancer. Gram-positive infections were most common, but the incidence of gram-negative infections increased at a greater rate. Compared with patients without cancer, those with cancer had significantly higher rates of lower respiratory tract (35.0% vs 31.6%), intra-abdominal (5.5% vs 4.6%), fungal (4.8% vs 2.9%), and anaerobic (1.2% vs 0.9%) infections. Sepsis incidence increased at a higher rate in patients with cancer than in those without cancer, but hospital mortality rates improved equally in both groups. After propensity score matching, hospital mortality was higher in patients with cancer than in those without cancer (hazard ratio, 1.25; 95% CI, 1.24-1.26). Of patients with sepsis and cancer, those with lung cancer had the lowest survival (hazard ratio, 1.65) compared with those with breast cancer, who had the highest survival. Conclusions Cancer patients are at high risk for sepsis and associated mortality. Research is needed to guide sepsis monitoring and prevention in patients with cancer.

scholarly journals Derivation and Validation of Clinical Prediction Models for Rapid Risk Stratification for Time-Sensitive Management for Acute Heart Failure

2020 ◽  
Vol 9 (11) ◽  
pp. 3394
Author(s):  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Takayuki Abe ◽  
Toshiyuki Nagai ◽  
Ayumi Goda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Stratification ◽  
Hospital Mortality ◽  
Acute Heart Failure ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Validation Dataset ◽  
Stepwise Logistic Regression ◽  
Early Presentation ◽  
C Statistic

Early and rapid risk stratification of patients with acute heart failure (AHF) is crucial for appropriate patient triage and outcome improvements. We aimed to develop an easy-to-use, in-hospital mortality risk prediction tool based on data collected from AHF patients at their initial presentation. Consecutive patients’ data pertaining to 2006–2017 were extracted from the West Tokyo Heart Failure (WET-HF) and National Cerebral and Cardiovascular Center Acute Decompensated Heart Failure (NaDEF) registries (n = 4351). Risk model development involved stepwise logistic regression analysis and prospective validation using data pertaining to 2014–2015 in the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure Syndrome (REALITY-AHF) (n = 1682). The final model included data describing six in-hospital mortality risk predictors, namely, age, systolic blood pressure, blood urea nitrogen, serum sodium, albumin, and natriuretic peptide (SOB-ASAP score), available at the time of initial triage. The model showed excellent discrimination (c-statistic = 0.82) and good agreement between predicted and observed mortality rates. The model enabled the stratification of the mortality rates across sixths (from 14.5% to <1%). When assigned a point for each associated factor, the integer score’s discrimination was similar (c-statistic = 0.82) with good calibration across the patients with various risk profiles. The models’ performance was retained in the independent validation dataset. Promptly determining in-hospital mortality risks is achievable in the first few hours of presentation; they correlate strongly with mortality among AHF patients, potentially facilitating clinical decision-making.

Importance of diagnostic setting in determining mortality in patients with new-onset heart failure: temporal trends in Denmark 1997–2017

2021 ◽  
Author(s):  
Anojhaan Arulmurugananthavadivel ◽  
Anders Holt ◽  
Saaima Parveen ◽  
Morten Lamberts ◽  
Gunnar H Gislason ◽  
...  
Keyword(s):  
Heart Failure ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Outpatient Setting ◽  
Lower Mortality ◽  
Risk Of Death ◽  
Hospitalization Rates ◽  
Standardized Mortality Rate ◽  
Subsequent Risk ◽  
New Onset

Abstract Aim To investigate temporal trends in in-patient versus out-patient diagnosis of new-onset heart failure (HF) and the subsequent risk of death and hospitalization. Methods and results Using nationwide registers, 192,581 patients with a first diagnosis of HF (1997–2017) were included. We computed incidences of HF, age-standardized mortality rates, and absolute risks (AR) of death and hospitalization (accounting for competing risk of death) to understand the importance of the diagnosis setting in relation to subsequent mortality and hospitalization. The overall incidence of HF was approximately the same (170/100,000 persons) every year during 1997–2017. However, in 1997, 77% of all first diagnoses of HF were made during a hospitalization, whereas the proportion was 39% in 2017. As in-patient diagnoses decreased, out-patient diagnoses increased from 23% to 61%. Out-patients had lower mortality and hospitalization rates than in-patients throughout the study period, although the 1-year age-standardized mortality rate decreased for each of in-patients (24 to 14/100-person) and out-patients (11 to 7/100-person). 1-year and 5-year AR of death decreased by 11.1% and 17.0%, respectively, for all HF patients, while the risk of hospitalization for HF did not decrease significantly (1.13% and 0.96%, respectively). Conclusions Between 1997 and 2017, HF changed from being primarily diagnosed during hospitalization to being mostly diagnosed in the outpatient setting. Out-patients had much lower mortality rates than in-patients throughout the study period. Despite a significant decrease in mortality risk for all HF patients, neither in-patients nor out-patients experienced a reduction in the risk of a HF hospitalization.

scholarly journals Generalisability of Randomised Controlled Trials in Heart Failure with Reduced Ejection Fraction

2021 ◽  
Author(s):  
Yvonne Mei Fong Lim ◽  
Megan Molnar ◽  
Ilonca Vaartjes ◽  
Gianluigi Savarese ◽  
Marinus J C Eijkemans ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiovascular Mortality ◽  
Mortality Rates ◽  
Clinical Event ◽  
Case Mix ◽  
Reduced Ejection Fraction ◽  
All Cause Mortality ◽  
Trial Participants ◽  
Age And Sex

Abstract Background Heart failure (HF) trials have stringent in- and ex- clusion criteria, but limited data exists regarding generalisability of trials. We compared patient characteristics and outcomes between patients with HF and reduced ejection fraction (HFrEF) in trials and observational registries. Methods and Results Individual patient data for 16922 patients from five randomised clinical trials and 46914 patients from two HF registries were included. The registry patients were categorised into trial-eligible and non-eligible groups using the most commonly used in- and ex-clusion criteria. A total of 26104 (56%) registry patients fulfilled the eligibility criteria. Unadjusted all-cause mortality rates at one year were lowest in the trial population (7%), followed by trial-eligible patients (12%) and trial-non-eligible registry patients (26%). After adjustment for age and sex, all-cause mortality rates were similar between trial participants and trial-eligible registry patients (standardised mortality ratio (SMR) 0.97; 95% confidence interval (CI) 0.92 -1.03) but cardiovascular mortality was higher in trial participants (SMR 1.19; 1.12 -1.27). After full case-mix adjustment, the SMR for cardiovascular mortality remained higher in the trials at 1.28 (1.20- 1.37) compared to RCT-eligible registry patients. Conclusion In contemporary HF registries, over half of HFrEF patients would have been eligible for trial enrolment. Crude clinical event rates were lower in the trials, but, after adjustment for case-mix, trial participants had similar rates of survival as registries. Despite this, they had about 30% higher cardiovascular mortality rates. Age and sex were the main drivers of differences in clinical outcomes between HF trials and observational HF registries.

scholarly journals Mortality after hospital admission for heart failure: improvement over time, equally strong in women as in men

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Buddeke ◽  
◽  
G. B. Valstar ◽  
I. van Dis ◽  
F. L. J. Visseren ◽  
...  
Keyword(s):  
Heart Failure ◽  
Absolute Risk ◽  
Mortality Rates ◽  
Dutch Hospital ◽  
Term Survival ◽  
Risk Of Death ◽  
Over Time ◽  
Age And Sex ◽  
New Onset

Abstract Background To assess the trend in age- and sex-stratified mortality after hospitalization for heart failure (HF) in the Netherlands. Methods Two nationwide cohorts of patients, hospitalized for new onset heart failure between 01.01.2000–31.12.2002 and between 01.01.2008–31.12.2010, were constructed by linkage of the Dutch Hospital Discharge Registry and the National Cause of Death registry. 30-day, 1-year and 5 -year overall and cause-specific mortality rates stratified by age and sex were assessed and compared over time. Results We identified 40,230 men and 41,582 women. In both cohorts, men were on average younger than women (74–75 and 78–79 years, respectively) and more often had comorbid conditions (37 and 30%, respectively). In the 2008–10 cohort, mortality rates for men were 13, 32 and 64% for respectively 30-day, 1-year and 5-year mortality and 14, 33 and 66% for women. Mortality rates increased considerably with age similarly in men and women (e.g. from 10.5% in women aged 25–54 to 46.1% in those aged 85 and older after 1 year). Between the two time periods, mortality rates dropped across all ages, equally strong in women as in men. The 1-year absolute risk of death declined by 4.0% (from 36.1 to 32.1%) in men and 3.2% (from 36.2 to 33.0%) in women. Conclusions Mortality after hospitalization for new onset HF remains high, however, both short-term and long-term survival is improving over time. This improvement was similar across all ages and equally strong in women as in men.

Abstract 270: Temporal Trends in Heart Failure Mortality in an Integrated Healthcare Delivery System, California and the US, 2001-2017

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Matthew Mefford ◽  
Zimin Zhuang ◽  
Zhi Liang ◽  
Wansu Chen ◽  
Heather Watson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Temporal Trends ◽  
Healthcare Delivery ◽  
Mortality Rates ◽  
Healthcare Delivery System ◽  
Kaiser Permanente ◽  
Annual Percent Change ◽  
The Us ◽  
State Death ◽  
Us Census

Background: In recent years declines in the rate of mortality attributable to cardiovascular diseases have slowed and mortality attributable to heart failure (HF) has increased. Objective: To examine secular trends in mortality with HF as the underlying cause in Kaiser Permanente Southern California (KPSC), California, and the US among adults 45 years of age and older from 2001 and 2017. Methods: KPSC mortality rates with HF as an underlying cause from 2001 to 2017 were derived through linkage with California State death files and were compared with rates in California and the US. Rates were age-standardized to the 2000 US Census population. Trends were examined overall and among men and women, separately, using best-fit Joinpoint regression models. Average annual percent change (AAPC) and 95% confidence intervals (CI) were calculated for the overall study period, and within earlier (2001-2011) and later (2011-2017) time periods. Results: Between 2001-2017, age-adjusted mortality rates with HF as the underlying cause were lower comparing KPSC to California and the US. In KPSC, rates increased from 23.9 to 44.7 per 100,000 person-years (PY) in KPSC, representing an AAPC of 1.3% (95% CI 0.0%, 2.6%). (Table) During the same time period, HF mortality rates in California also increased from 33.9 to 46.5 per 100,000 PY (AAPC 1.5%, 95% CI 0.3%, 2.7%), while remaining unchanged in the US at 57.9 per 100,000 PY in 2001 and 2017 (AAPC 0.0%, 95% CI -0.5%, 0.5%). AAPCs were not statistically different comparing KPSC to both California and the US (all p > 0.05). Between 2001-2011, rates of HF mortality increased in KPSC (AAPC 1.3%, 95% CI 0.0, 2.6), non-significantly increased in California (AAPC 0.2%, 95% CI -0.8%, 1.2%) and decreased in the US (AAPC -2.1%, 95% CI -2.7%, -1.5%). Between 2011-2017, rates of HF mortality increased in KPSC (AAPC 1.3%, 95% CI 0.0%, 2.6%), California (AAPC 3.7%, 95% CI 1.0%, 6.5%), and the US (AAPC 3.6%, 95% CI 2.4%, 4.8%) except among KPSC women (AAPC 0.3% [95% CI -1.6%, 2.2%]). Conclusion: Despite increases in HF mortality after 2011, rates of HF mortality were lower among KPSC compared to California and the US. Given the mortality burden of HF at older age, there is a need to improve HF prevention, treatment and management efforts earlier in life.

Temporal trends, sex-differences and outcomes of patients hospitalized for heart failure in Germany

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Goebel ◽  
L Hobohm ◽  
T Gori ◽  
M.A Ostad ◽  
T Muenzel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sex Differences ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Temporal Trends ◽  
Case Fatality ◽  
Adverse Outcomes ◽  
Funding Source ◽  
National Budget ◽  
Public Grant

Abstract Background Despite remarkable improvements in treatment of cardiovascular disease, heart failure (HF) is still characterized by a high mortality rate. Sex-specific differences in HF have been described, but underlying reasons are widely unexplored. Thus, we aimed to investigate sex differences of patients hospitalized for HF in a nationwide cohort. Methods The nationwide German inpatient sample (2005–2016) was used for this sex-specific analyses. Temporal trends on hospitalizations, mortality, and treatments were analyzed and independent predictors of adverse outcomes identified. Results The present analysis comprises 4,538,977 hospitalizations due to HF (52.0%women) in Germany (2005–2016). Although women were older (median 82 (IQR75–87) vs. 76 (69–82), P&lt;0.001), coronary artery disease (CAD, 50.3% vs. 30.7%, P&lt;0.001) was more prevalent in men, who were more often treated with PCI (3.4% vs. 1.4%, P&lt;0.001) and implantable cardioverter-defibrillator (2.2% vs. 0.5%, P&lt;0.001). In-hospital mortality was significantly lower in men than in women (8.9% vs. 10.2, P=0.001) and was reduced in patients who received PCI or implantation of an ICD. While total numbers of hospitalizations between 2005 and 2016 increased in both men (β-estimate 7185.71 (95% CI 6502.23 to 7869.18), P&lt;0.001) and women (β-estimate 5297.60 (95% CI 4557.37 to 6037.83), P&lt;0.001) as well as almost all comorbid co-conditions, in-hospital mortality rate decreased more distinctly in women (β-estimate −0.41 (95% CI: −0.42 to −0.39), P&lt;0.001) compared to men (β-estimate −0.29 (95% CI: −0.30 to −0.27), P&lt;0.001). Conclusions Interventional treatments of HF were associated with improved outcomes and equally beneficial for both sexes. However, they were more often used in male HF patients, in which CAD is significantly more frequent than in female HF patients. This may explain the higher case fatality rate of HF in females. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German Federal Ministry of Education and Research (BMBF)

scholarly journals Temporal trends in heart failure mortality in an integrated healthcare delivery system, California, and the US, 2001–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthew T. Mefford ◽  
Zimin Zhuang ◽  
Zhi Liang ◽  
Wansu Chen ◽  
Sandra Y. Koyama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Temporal Trends ◽  
Healthcare Delivery ◽  
Mortality Rates ◽  
Healthcare Delivery System ◽  
Kaiser Permanente ◽  
Related Factors ◽  
Annual Percent Change ◽  
The Us ◽  
State Death

Abstract Background In recent years, decreases in mortality rates attributable to cardiovascular diseases have slowed but mortality attributable to heart failure (HF) has increased. Methods Between 2001–2017, trends in age-adjusted mortality with HF as an underlying cause for Kaiser Permanente Southern California (KPSC) members were derived through linkage with state death files and compared with trends among California residents and the US. Average annual percent change (AAPC) and 95% confidence intervals (CI) were calculated using Joinpoint regression. Analyses were repeated examining HF as a contributing cause of death. Results In KPSC, the age-adjusted HF mortality rates were comparable to California but lower than the US, increasing from 23.9 per 100,000 person-years (PY) in 2001 to 44.7 per 100,000 PY in 2017, representing an AAPC of 1.3% (95% CI 0.0%, 2.6%). HF mortality also increased in California from 33.9 to 46.5 per 100,000 PY (AAPC 1.5%, 95% CI 0.3%, 2.7%), while remaining unchanged in the US at 57.9 per 100,000 PY in 2001 and 2017 (AAPC 0.0%, 95% CI − 0.5%, 0.5%). Trends among KPSC members ≥ 65 years old were similar to the overall population, while trends among members 45–64 years old were flat between 2001–2017. Small changes in mortality with HF as a contributing cause were observed in KPSC members between 2001 and 2017, which differed from California and the US. Conclusion Lower rates of HF mortality were observed in KPSC compared to the US. Given the aging of the US population and increasing prevalence of HF, it will be important to examine individual and care-related factors driving susceptibility to HF mortality.

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