美国、英国、台湾地区和日本的心力衰竭住院情况：对413,385名个体患者的行政健康记录进行的国际比较。
Hospitalization for Heart Failure in the United States, UK, Taiwan, and Japan: An International Comparison of Administrative Health Records on 413,385 Individual Patients.
作者信息
Sundaram Varun, Nagai Toshiyuki, Chiang Chern-En, Reddy Yogesh N V, Chao Tze-Fan, Zakeri Rosita, Bloom Chloe, Nakai Michikazu, Nishimura Kunihiro, Hung Chung-Lieh, Miyamoto Yoshihiro, Yasuda Satoshi, Banerjee Amitava, Anzai Toshihisa, Simon Daniel I, Rajagopalan Sanjay, Cleland John G F, Sahadevan Jayakumar, Quint Jennifer K
机构信息
Department of Medicine, Louis Stokes Veteran Affairs Medical Center, Cleveland, Ohio; Department of Cardiovascular Medicine, Harington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio; Department of Population Science and Gene Health, National Heart & Lung Institute, Imperial College London, London, UK; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Department of Population Science and Gene Health, National Heart & Lung Institute, Imperial College London, London, UK; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
出版信息
J Card Fail. 2022 Mar;28(3):353-366. doi: 10.1016/j.cardfail.2021.08.024. Epub 2021 Oct 8.
BACKGROUND
Registries show international variations in the characteristics and outcome of patients with heart failure (HF), but national samples are rarely large, and case selection may be biased owing to enrolment in academic centers. National administrative datasets provide large samples with a low risk of bias. In this study, we compared the characteristics, health care resource use (HRU) and outcomes of patients with primary HF hospitalizations (HFH) using electronic health records (EHR) from 4 high-income countries (United States, UK, Taiwan, Japan) on 3 continents.
METHODS AND RESULTS
We used electronic health record to identify unplanned HFH between 2012 and 2014. We identified 231,512, 10,991, 36,900, and 133,982 patients with a primary HFH from the United States, the UK, Taiwan, and Japan, respectively. HFH per 100,000 population was highest in the United States and lowest in Taiwan. Fewer patients in Taiwan and Japan were obese or had chronic kidney disease. The length of hospital stay was shortest in the United States (median 4 days) and longer in the UK, Taiwan, and Japan (medians of 7, 9, and 17 days, respectively). HRU during hospitalization was highest in Japan and lowest in UK. Crude and direct standardized in-hospital mortality was lowest in the United States (direct standardized rates 1.8, 95% confidence interval 1.7%-1.9%) and progressively higher in Taiwan (direct standardized rates 3.9, 95% CI 3.8%-4.1%), the UK (direct standardized rates 6.4, 95% CI 6.1%-6.7%), and Japan (direct standardized rates 6.7, 95% CI 6.6%-6.8%). The 30-day all-cause (25.8%) and HF (7.2%) readmissions were highest in the United States and lowest in Japan (11.9% and 5.1%, respectively).
CONCLUSIONS
Marked international variations in patient characteristics, HRU, and clinical outcomes exist; understanding them might inform health care policy and international trial design.
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