蒙特利尔老年充血性心力衰竭患者的死亡率和住院率变化趋势

Changing trends in mortality and admissions to hospital for elderly patients with congestive heart failure in Montreal.

作者信息

Feldman D E, Thivierge C, Guérard L, Déry V, Kapetanakis C, Lavoie G, Beck E J

机构信息

Direction de la Santé Publique de Montréal Centre, and Département de médecine sociale et préventive, Université de Montréal, Que.

出版信息

CMAJ. 2001 Oct 16;165(8):1033-6.

PMID:11699698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC81537/

Abstract

BACKGROUND

Congestive heart failure (CHF) is a common disease requiring admission to hospital among elderly people and is associated with a high mortality rate. The objective of this study was to examine trends in CHF mortality and admissions to hospital in Montreal between 1990 and 1997 for individuals aged 65 years or more.

METHODS

We obtained information about deaths from the Quebec Death Certificate Registry database and information about admissions to hospital from the Quebec Med-Echo database. Patients with a primary diagnosis that was classified as ICD-9 code 428 were considered cases of CHF.

RESULTS

Although age-adjusted rates of mortality from CHF did not change significantly between 1990 and 1997, the annual rate of admission to hospital for CHF increased from 92 per 10,000 population in 1990/91 to 124 per 10,000 population in 1997/98 (p < 0.01). Deaths due to CHF, expressed as a proportion of all cardiovascular deaths, increased among women from 5.6% in 1990 to 6.2% in 1997 (p = 0.01). The rate of readmission for all causes following a first admission for CHF during that year rose over the study period from 16.6% to 22.0% within one month (p < 0.001) and from 46.7% to 49.4% within 6 months (p = 0.03). Conversely, mean annual length of stay per admission decreased from 16.4 days in 1990/91 to 12.2 days in 1997/98.

INTERPRETATION

The increase in rates of admission to hospital for CHF and the stable rates of CHF mortality suggest that the management of CHF and its antecedents has improved in recent years.

摘要

背景

充血性心力衰竭（CHF）是老年人中需要住院治疗的常见疾病，且死亡率很高。本研究的目的是调查1990年至1997年期间，蒙特利尔市65岁及以上人群中CHF死亡率和住院率的变化趋势。

方法

我们从魁北克死亡证明登记数据库中获取死亡信息，并从魁北克医疗回声数据库中获取住院信息。主要诊断被分类为国际疾病分类第九版（ICD-9）代码428的患者被视为CHF病例。

结果

尽管1990年至1997年期间，经年龄调整的CHF死亡率没有显著变化，但CHF的年住院率从1990/91年的每10000人92例增加到1997/98年的每10000人124例（p<0.01）。CHF导致的死亡占所有心血管疾病死亡的比例，在女性中从1990年的5.6%上升到1997年的6.2%（p = 0.01）。在该年首次因CHF住院后，所有原因的再入院率在研究期间内，1个月内从16.6%上升到22.0%（p<0.001），6个月内从46.7%上升到49.4%（p = 0.03）。相反，每次住院的平均年住院天数从1990/91年的16.4天减少到1997/98年的12.2天。