Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America.
Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America.
Int J Cardiol. 2021 May 1;330:98-105. doi: 10.1016/j.ijcard.2021.02.031. Epub 2021 Feb 17.
To analyze the age-specific temporal trends, in-hospital outcomes and readmissions for acute heart failure (HF).
There is a paucity of data on the age-specific differences in the trends and outcomes of hospitalizations with acute HF.
The National Inpatients Sample database years 2002-2016 and the National Readmissions Database years 2013-2016 were used to identify primary hospitalizations for acute HF. We analyzed the age-specific temporal trends, in-hospital outcomes, and readmissions for acute HF.
The annual rate of hospitalizations for acute HF declined from 456 per 100,000 people in 2002 to 356 per 100,000 people in 2016 (P < 0.001). The decline was observed among all age groups, except those aged 18-44 years. There was a decline in in-hospital mortality among all age groups, except for those aged 18-34 years. Compared with 18-34 years, adjusted in-hospital mortality was lower among 35-44 years (odds ratio 0.78, 95% confidence interval [CI] 0.74-0.82) and 45-54 years (OR 0.87; 95% CI 0.83-0.91) but higher among 55-64 years (OR 1.60; 95% CI 1.54-1.67) and ≥ 75 year (OR 2.54; 95% CI 2.44-2.64). Compared with 18-34 years, 30-day HF-related readmissions were significantly lower in older age groups (>34 years).
This nationwide contemporary analysis demonstrated a decline in the annual rates of hospitalizations with acute HF across all age categories except those aged 18-44 years. There was a reduction in rates of in-hospital mortality among middle-aged and older patients, but not in those aged 18-34. In-hospital mortality exhibited a dichotomous relationship with age. There was an inverse relationship between age and 30-days HF readmissions.
分析急性心力衰竭（HF）住院患者的年龄特异性时间趋势、院内结局和再入院情况。
关于急性 HF 住院患者的趋势和结局的年龄特异性差异，数据较少。
使用 2002 年至 2016 年的全国住院患者样本数据库和 2013 年至 2016 年的全国再入院数据库，确定急性 HF 的初次住院。我们分析了急性 HF 的年龄特异性时间趋势、院内结局和再入院情况。
急性 HF 住院的年发生率从 2002 年的每 100000 人 456 例降至 2016 年的每 100000 人 356 例（P<0.001）。除 18-44 岁年龄组外，所有年龄组的发生率均有所下降。除 18-34 岁年龄组外，所有年龄组的院内死亡率均有所下降。与 18-34 岁年龄组相比，35-44 岁（比值比 0.78，95%置信区间 [CI] 0.74-0.82）和 45-54 岁（OR 0.87；95% CI 0.83-0.91）年龄组的调整后院内死亡率较低，但 55-64 岁（OR 1.60；95% CI 1.54-1.67）和≥75 岁（OR 2.54；95% CI 2.44-2.64）年龄组的死亡率较高。与 18-34 岁年龄组相比，30 天 HF 相关再入院率在年龄较大的年龄组（>34 岁）显著降低。
这项全国性的现代分析表明，除 18-44 岁年龄组外，所有年龄组的急性 HF 住院率均呈下降趋势。中年和老年患者的住院死亡率有所下降，但 18-34 岁患者的死亡率没有下降。院内死亡率与年龄呈二项关系。年龄与 30 天 HF 再入院率呈反比关系。
