Department of Heart Failure and Transplantology, National Institute of Cardiology, Warsaw, Poland.
Department of Analysis and Strategy, Ministry of Health, Warsaw, Poland.
ESC Heart Fail. 2022 Jun;9(3):1553-1563. doi: 10.1002/ehf2.13900. Epub 2022 Mar 24.
We aim to report trends in unplanned hospitalizations among newly diagnosed heart failure patients with regard to hospitalizations types and their impact on outcomes.
A nation-wide study of all citizens in Poland with newly diagnosed heart failure based on ICD-10 coding who were beneficiaries of either public primary, secondary, or hospital care between 2013 and 2018 in Poland. Between 1 January 2013 and 31 December 2019, there were 1 124 118 newly diagnosed heart failure patients in Poland in both out- and inpatient settings. The median observation time was 946 days. As many as 49% experienced at least one acute heart failure hospitalization. Once hospitalized, 44.6% patients experienced at least one all-cause rehospitalization and 26% another heart failure rehospitalization. The latter had the highest Charlson co-morbidity index (1.36). The 30 day heart failure readmission rate was 2.96%. Kaplan-Meier analysis revealed very early readmissions (up to 1-7 days) were associated with better survival compared with rehospitalization between 8 and 30 days. All-cause mortality was related to the number of hospitalization with adjusted estimated hazard ratios: 1.550 (95% CI: 1.52-158) for the second HF hospitalization, 2.158 (95% CI: 2.098-2.219) for third, and 2.788 (95% CI: 2.67-2.91) for the fourth HF hospitalization and subsequent ones, as compared with the first hospitalization.
Among newly diagnosed heart failure patients in Poland between 2013 and 2019, nearly half required at least one unplanned heart failure hospitalization. The risk of death was growing with every other hospital reoccurrence due to heart failure.
本研究旨在报告新诊断心力衰竭患者非计划性住院的趋势，包括住院类型及其对结局的影响。
本研究为一项全国性研究，纳入了 2013 年至 2018 年期间波兰所有符合 ICD-10 编码的新诊断心力衰竭患者，他们享受公共初级、二级或医院护理。在波兰，2013 年 1 月 1 日至 2019 年 12 月 31 日期间，有 1184118 例新诊断心力衰竭患者在门诊和住院环境中接受治疗。中位观察时间为 946 天。多达 49%的患者至少经历过一次急性心力衰竭住院。一旦住院，44.6%的患者至少经历过一次全因再住院，26%的患者经历过另一次心力衰竭再住院。后者的 Charlson 合并症指数最高（1.36）。30 天心力衰竭再入院率为 2.96%。Kaplan-Meier 分析显示，与 8-30 天的再住院相比，早期（1-7 天）再入院与更好的生存相关。全因死亡率与住院次数相关，调整后的估计风险比为：第二次心力衰竭住院 1.550（95%CI：1.52-158），第三次住院 2.158（95%CI：2.098-2.219），第四次及以后的心力衰竭住院 2.788（95%CI：2.67-2.91），与第一次住院相比。
在 2013 年至 2019 年期间，波兰新诊断心力衰竭患者中，近一半的患者需要至少一次非计划性心力衰竭住院治疗。由于心力衰竭再次住院，死亡风险随着每次住院而增加。
