3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Center for Heart Disease in Zabrze, M. Curie-Sklodowskiej 9, 41-800 Zabrze, Poland.
Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Ziołowa 45/47, 40-635 Katowice, Poland.
Int J Cardiol. 2018 Nov 15;271:146-151. doi: 10.1016/j.ijcard.2018.05.015.
Heart failure (HF) continues to be an important medical and social problem, with high morbidity and mortality. Data on the trends in hospitalizations, hospital readmissions and mortality is of great importance both from the epidemiological and clinical points of view.
We analyzed the secular trends in first-time hospital admissions for heart failure between 2010 and 2016, derived from SILCARD database, covering a population of 3.8 million adults. Patient characteristics as well as data on in-hospital and 12-month outcomes were recorded for each year. The total number of first-time hospitalizations for HF as the primary diagnosis showed a downward trend during the study period (reduction by 12%, p = 0.07), with a constant patient age (mean 74.3 ± 11.3 years). The length of hospital stay shortened from 10.9 to 9.6 days (p = 0.003). Crude in-hospital mortality remained constant at around 14% (p = 0.55), but after adjustment for sex and age, mortality rates tended to decrease from 17.2% in 2010 to 11.5% in 2016 (p = 0.007). All-cause hospital readmission rates in 12-month follow-up increased which was due to non-CV hospitalizations, since both CV- and HF-related readmissions were constant throughout the years. Crude 12-month mortality was constant, but after adjustment for age and sex absolute reduction by about 10% was found (p = 0.02).
Despite the decreasing duration of hospital stay, significant improvement in both in-hospital and long-term survival was observed, with constant rates of hospital readmissions related to HF.
心力衰竭（HF）仍然是一个重要的医学和社会问题，具有较高的发病率和死亡率。从流行病学和临床角度来看，有关住院、再住院和死亡率趋势的数据非常重要。
我们分析了 2010 年至 2016 年期间首次因心力衰竭住院的人群，这些数据来自 SILCARD 数据库，涵盖了 380 万成年人。记录了每年患者的特征以及住院和 12 个月的结局数据。首次因心力衰竭住院的总人数呈下降趋势（减少 12%，p=0.07），而患者年龄保持不变（平均 74.3±11.3 岁）。住院时间从 10.9 天缩短至 9.6 天（p=0.003）。住院期间的粗死亡率保持在 14%左右（p=0.55），但经过性别和年龄调整后，死亡率从 2010 年的 17.2%下降至 2016 年的 11.5%（p=0.007）。12 个月随访时全因再住院率增加，这是由于非心血管住院所致，因为心血管和心力衰竭相关再住院率在整个研究期间保持不变。住院期间的粗死亡率保持不变，但经过年龄和性别调整后，绝对死亡率下降了约 10%（p=0.02）。
尽管住院时间缩短，但住院期间和长期生存率均显著提高，与心力衰竭相关的再住院率保持不变。
