Stafylas P, Farmakis D, Kourlaba G, Giamouzis G, Tsarouhas K, Maniadakis N, Parissis J
University of Macedonia, Thessaloniki, Greece.
Attikon University Hospital, Athens, Greece.
Int J Cardiol. 2017 Jan 15;227:923-929. doi: 10.1016/j.ijcard.2016.10.042. Epub 2016 Oct 17.
The objective of this study was to identify the epidemiological and clinical characteristics of heart failure (HF) patients in Greece as well as the economic burden and the distribution of costs for the management of the disease.
Eight Greek secondary and tertiary cardiology centres from different cities have participated in a prospective, observational survey, the ESC HF Pilot Survey. 307 patients with HF, 177 hospitalised and 130 outpatients, have been recruited and monitored for 12months. Clinical and epidemiological data, along with data on mortality, hospitalisations and health care resources used have been collected. The economic evaluation was conducted from the social security system perspective.
The annual mortality rate was 24.3% for the hospitalised patients vs 7.7% for the outpatients (P<0.001) and the annual rehospitalisation rate was 42.9% vs 19.2% respectively (P<0.001). Kaplan-Meier analyses revealed that patients with kidney dysfunction, S3 gallop and higher NYHA class have a significantly worse survival. The mean annual economic burden of the social security system per HF patient was estimated at €4411±4764. About two thirds of this cost is due to in-patient care.
Despite the progress in the management of the disease, about one in four hospitalised patients dies and four in ten are rehospitalised in less than one year. Moreover, the disease imposes a significant economic burden for the social security system and national economy. Their findings suggest that there is still need of more effective drug treatment and efficient disease management programs focused in the reduction of the hospital admissions.
本研究的目的是确定希腊心力衰竭（HF）患者的流行病学和临床特征，以及该疾病管理的经济负担和成本分布。
来自希腊不同城市的8个二级和三级心脏病中心参与了一项前瞻性观察性调查，即欧洲心脏病学会心力衰竭试点调查。招募了307例HF患者，其中177例住院患者和130例门诊患者，并对其进行了12个月的监测。收集了临床和流行病学数据，以及死亡率、住院率和医疗资源使用情况的数据。从社会保障系统的角度进行了经济评估。
住院患者的年死亡率为24.3%，门诊患者为7.7%（P<0.001），年再住院率分别为42.9%和19.2%（P<0.001）。Kaplan-Meier分析显示，肾功能不全、S3奔马律和纽约心脏协会（NYHA）分级较高的患者生存率明显较差。估计社会保障系统每位HF患者的年均经济负担为4411±4764欧元。其中约三分之二的费用是由于住院治疗。
尽管在该疾病的管理方面取得了进展，但仍有四分之一的住院患者死亡，十分之四的患者在不到一年的时间内再次住院。此外，该疾病给社会保障系统和国民经济带来了巨大的经济负担。他们的研究结果表明，仍然需要更有效的药物治疗和以减少住院率为重点的高效疾病管理计划。
