Ciapponi Agustín, Alcaraz Andrea, Calderón María, Matta María Gabriela, Chaparro Martin, Soto Natalie, Bardach Ariel
Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
Departamento de Revisiones Sistemáticas, Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina.
Rev Esp Cardiol (Engl Ed). 2016 Nov;69(11):1051-1060. doi: 10.1016/j.rec.2016.04.054. Epub 2016 Aug 21.
Heart failure is a major public health concern. The aim of this review was to estimate the burden of heart failure in Latin America.
Systematic review and meta-analysis following a search in MEDLINE, EMBASE, LILACS, and CENTRAL for articles published between January 1994 and June 2014, with no language restrictions. We included experimental and observational studies with at least 50 participants aged ≥ 18 years.
In total, 143 of the 4792 references retrieved were included in the study. Most studies had been conducted in South America (92%), and mainly in Brazil (64%). The mean age of the patients was 60 ± 9 years, and mean ejection fraction was 36% ± 9%. The incidence of heart failure in the single population study providing this information was 199 cases per 100000 person-years. The prevalence of heart failure was 1% (95% confidence interval [95%CI], 0.1%-2.7%); hospital readmission rates were 33%, 28%, 31%, and 35% at 3, 6, 12, and 24 to 60 months of follow-up, respectively; and the median duration of hospitalization was 7.0 days. The 1-year mortality rate was 24.5% (95%CI, 19.4%-30.0%). In-hospital mortality was 11.7% (95%CI, 10.4%-13.0%), and the rate was higher in patients with a reduced ejection fraction, ischemic heart disease, or Chagas disease.
Few studies have evaluated the incidence and prevalence of heart failure in Latin America. High mortality and hospitalization rates were found, and the main limitation was heterogeneity between studies. The results presented provide useful epidemiologic information for decision-making related to this disease. Further studies with standardized methods and representative populations are needed in this line.
心力衰竭是一个重大的公共卫生问题。本综述的目的是评估拉丁美洲心力衰竭的负担。
在MEDLINE、EMBASE、LILACS和CENTRAL数据库中检索1994年1月至2014年6月发表的文章，进行系统综述和荟萃分析，无语言限制。我们纳入了至少有50名年龄≥18岁参与者的实验性和观察性研究。
在检索到的4792篇参考文献中，共有143篇被纳入研究。大多数研究在南美洲进行（92%），主要在巴西（64%）。患者的平均年龄为60±9岁，平均射血分数为36%±9%。提供此信息的单人群研究中，心力衰竭的发病率为每100000人年199例。心力衰竭的患病率为1%（95%置信区间[95%CI]，0.1%-2.7%）；在3、6、12以及24至60个月的随访中，医院再入院率分别为33%、28%、31%和35%；住院时间中位数为7.0天。1年死亡率为24.5%（95%CI，19.4%-30.0%）。住院死亡率为11.7%（95%CI，10.4%-13.0%），在射血分数降低、缺血性心脏病或恰加斯病患者中该比率更高。
很少有研究评估拉丁美洲心力衰竭的发病率和患病率。发现死亡率和住院率较高，主要局限性是研究之间的异质性。所呈现的结果为与该疾病相关的决策提供了有用的流行病学信息。为此需要采用标准化方法并针对具有代表性人群开展进一步研究。
