Jain Vardhman, Minhas Abdul Mannan Khan, Khan Safi U, Greene Stephen J, Pandey Ambarish, Van Spall Harriette G C, Fonarow Gregg C, Mentz Robert J, Butler Javed, Khan Muhammad Shahzeb
Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Medicine, Forrest General Hospital, Hattiesburg, Mississippi, USA.
JACC Heart Fail. 2022 May;10(5):350-362. doi: 10.1016/j.jchf.2022.01.021.
The aim of this study was to assess trends in heart failure (HF) hospitalizations among young adults.
Data are limited regarding clinical characteristics and outcomes of young adults hospitalized for HF.
The National Inpatient Sample database was analyzed to identify adults aged 18 to 45 years who were hospitalized for HF between 2004 and 2018.
In total, 767,180 weighted hospitalizations for HF in young adults were identified, equivalent to 4.32 (95% CI: 4.31-4.33) per 10,000 person-years. Overall HF hospitalizations per 10,000 U.S. population of young adults decreased from 2.43 in 2004 to 1.82 in 2012, followed by an increase to 2.51 in 2018. Black adults (50.1%) had a significantly higher proportion of HF hospitalizations compared with White (31.9%) and Hispanic adults (12.2%) throughout the study period. Nearly half of patients (45.8%) lived in zip codes in the lowest quartile of national household income. Overall, in-hospital mortality was 1.3%, which decreased over time; this trend was consistent by sex and race. The overall mean LOS (5.2 days) remained stable over time, while the mean inflation-adjusted cost increased from $12,449 in 2004 to $16,786 in 2018, with significant overall differences by race and sex.
This longitudinal examination of U.S. clinical practice revealed that HF hospitalizations among young adults have increased since 2013. Approximately half of these patients are Black and reside in zip codes in the lowest quartile of national household income. Temporal trends showed decreased in-hospital mortality, stable adjusted lengths of stay, and increased inflation-adjusted costs, with significant racial differences in hospitalization rates.
本研究旨在评估年轻成年人中心力衰竭（HF）住院治疗的趋势。
关于因HF住院的年轻成年人的临床特征和预后的数据有限。
分析国家住院样本数据库，以确定2004年至2018年间因HF住院的18至45岁成年人。
总共确定了767,180例年轻成年人因HF的加权住院病例，相当于每10,000人年4.32例（95%CI：4.31 - 4.33）。每10,000名美国年轻成年人中的总体HF住院率从2004年的2.43降至2012年的1.82，随后在2018年增至2.51。在整个研究期间，黑人成年人（50.1%）的HF住院比例显著高于白人（31.9%）和西班牙裔成年人（12.2%）。近一半的患者（45.8%）居住在全国家庭收入最低四分位数的邮政编码区域。总体而言，住院死亡率为1.3%，且随时间下降；这一趋势在性别和种族方面是一致的。总体平均住院时间（5.2天）随时间保持稳定，而经通胀调整后的平均费用从2004年的12,449美元增加到2018年的16,786美元，在种族和性别方面存在显著的总体差异。
这项对美国临床实践的纵向研究表明，自2013年以来，年轻成年人中的HF住院率有所上升。这些患者中约一半是黑人，居住在全国家庭收入最低四分位数的邮政编码区域。时间趋势显示住院死亡率下降、调整后的住院时间稳定以及经通胀调整后的费用增加，住院率存在显著的种族差异。
