Fang Jing, Mensah George A, Croft Janet B, Keenan Nora L
Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3714, USA.
J Am Coll Cardiol. 2008 Aug 5;52(6):428-34. doi: 10.1016/j.jacc.2008.03.061.
The purpose of this study was to determine hospitalizations for heart failure in the U.S. during the past 26 years.
Heart failure increased in the U.S.; however, little is known about the long-term trends in diseases leading to hospitalizations among patients with heart failure.
Using National Hospital Discharge Survey data from 1979 to 2004, we assessed trends in hospitalizations for heart failure as either a first-listed or additional (2nd to 7th) diagnosis. Among hospitalizations with any mention of heart failure, we assessed the distribution of first-listed diagnoses.
The number of hospitalizations with any mention of heart failure tripled from 1,274,000 in 1979 to 3,860,000 in 2004; 65% to 70% of admissions were patients with additional diagnoses of heart failure. Heart failure hospitalization rates increased sharply with age. More than 80% of hospitalizations were among patients of at least 65 years and were paid by Medicare/Medicaid. Age-adjusted hospitalization rates between 1979 and 2004 increased for heart failure as either the first-listed or additional diagnosis. Whereas heart failure was the first-listed diagnosis for 30% to 35% of these hospitalizations, the proportion with respiratory diseases and noncardiovascular, nonrespiratory diseases as the first-listed diagnoses increased. Heart failure hospitalizations that resulted in transfers to long-term care facilities increased, and in-hospital mortality and length of hospital stay declined.
With the increased aging of the U.S. population and advanced therapeutic interventions that improve survival, it is expected that heart failure hospitalizations at older ages and the associated economic burden to Medicare will continue to increase in the future.
本研究旨在确定过去26年美国心力衰竭的住院情况。
美国心力衰竭病例有所增加；然而，对于导致心力衰竭患者住院的疾病的长期趋势了解甚少。
利用1979年至2004年的国家医院出院调查数据，我们评估了作为首要诊断或附加诊断（第2至第7位）的心力衰竭住院趋势。在任何提及心力衰竭的住院病例中，我们评估了首要诊断的分布情况。
任何提及心力衰竭的住院病例数量从1979年的127.4万例增至2004年的386万例，增长了两倍；65%至70%的入院患者为附加诊断心力衰竭的患者。心力衰竭住院率随年龄急剧上升。超过80%的住院患者年龄在65岁及以上，且费用由医疗保险/医疗补助支付。1979年至2004年期间，无论作为首要诊断还是附加诊断，心力衰竭的年龄调整住院率均有所上升。虽然心力衰竭是这些住院病例中30%至35%的首要诊断，但以呼吸系统疾病以及非心血管、非呼吸系统疾病作为首要诊断的比例有所增加。导致转至长期护理机构的心力衰竭住院病例增加，住院死亡率和住院时间下降。
随着美国人口老龄化加剧以及改善生存的先进治疗干预措施的出现，预计未来老年心力衰竭住院病例及医疗保险相关经济负担将持续增加。
