Cardiology Department, Hospital San Juan de la Cruz, Úbeda, Spain.
Cardiology Department, Hospital Reina Sofía, Córdoba, Spain.
Eur J Clin Invest. 2021 Nov;51(11):e13606. doi: 10.1111/eci.13606. Epub 2021 Jun 2.
Heart failure is one of the most pressing current public health concerns. However, in Spain there is a lack of population data. We aimed to examine thirteen-year nationwide trends in heart failure hospitalization, in-hospital mortality and 30-day readmission rates in Spain.
We conducted a retrospective observational study of patients discharged with the principal diagnosis of heart failure from The National Health System' acute hospitals during 2003-2015. The source of the data was the Minimum Basic Data Set. Temporal trends were modelled using Poisson regression analysis. The risk-standardized in-hospital mortality ratio was calculated using a multilevel risk adjustment logistic regression model.
A total of 1 254 830 episodes of heart failure were selected. Throughout 2003-2015, the number of hospital discharges with principal diagnosis of heart failure increased by 61%. Discharge rates weighted by age and sex increased during the period [incidence rate ratio (IRR): 1.03; 95% confidence interval (95% CI): 1.03-1.03; P < .001)], although this increase was motivated by the increase in older age groups (≥75 years old). The crude mortality rate diminished (IRR: 0.99; 95% CI: 0.98-1, P < .001), but 30-day readmission rate increased (IRR: 1.05; 95% CI: 1.04-1.06; P < .001). The risk-standardized in-hospital mortality ratio did not change throughout the study period (IRR: 0.997; 95% CI: 0.992-1; P = .32).
From 2003 to 2015, heart failure admission rates increased significantly in Spain as a consequence of the sustained increase of hospitalization in the population ≥75 years. 30-day readmission rates increased, but the risk-standardized in-hospital mortality ratio did not significantly change for the same period.
心力衰竭是当前最紧迫的公共卫生问题之一。然而，西班牙缺乏人口数据。我们旨在研究西班牙全国范围内心力衰竭住院、住院死亡率和 30 天再入院率的 13 年趋势。
我们对 2003 年至 2015 年期间从国家卫生系统急性医院出院的主要诊断为心力衰竭的患者进行了回顾性观察研究。数据来源是最低基本数据集。使用泊松回归分析对时间趋势进行建模。使用多水平风险调整逻辑回归模型计算风险标准化住院死亡率比。
共选择了 1254830 例心力衰竭发作。在 2003 年至 2015 年间，主要诊断为心力衰竭的住院出院人数增加了 61%。在该期间，按年龄和性别加权的出院率增加[发病率比 (IRR)：1.03；95%置信区间 (95% CI)：1.03-1.03；P<.001)]，尽管这一增长是由年龄较大的年龄组（≥75 岁）推动的。粗死亡率下降（IRR：0.99；95% CI：0.98-1，P<.001），但 30 天再入院率增加（IRR：1.05；95% CI：1.04-1.06；P<.001）。在整个研究期间，风险标准化住院死亡率没有变化（IRR：0.997；95% CI：0.992-1；P=.32）。
从 2003 年到 2015 年，由于≥75 岁人群住院人数持续增加，西班牙心力衰竭入院率显著增加。30 天再入院率增加，但同期风险标准化住院死亡率没有显著变化。
