Manemann Sheila M, Weston Susan A, Jiang Ruoxiang, Larson Nicholas B, Roger Véronique L, Takahashi Paul Y, Chamberlain Alanna M, Singh Mandeep, St Sauver Jennifer L, Bielinski Suzette J
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes. 2023 Jun;7(3):194-202. doi: 10.1016/j.mayocpiqo.2023.04.004. Epub 2023 Apr 13.
To compare the 1-year health care utilization and mortality in persons living with heart failure (HF) before and during the coronavirus disease 2019 (COVID-19) pandemic.
Residents of a 9-county area in southeastern Minnesota aged 18 years or older with a HF diagnosis on January 1, 2019; January 1, 2020; and January 1, 2021, were identified and followed up for 1-year for vital status, emergency department (ED) visits, and hospitalizations.
We identified 5631 patients with HF (mean age, 76 years; 53% men) on January 1, 2019, 5996 patients (mean age, 76 years; 52% men) on January 1, 2020, and 6162 patients (mean age, 75 years; 54% men) on January 1, 2021. After adjustment for comorbidities and risk factors, patients with HF in 2020 and patients with HF in 2021 experienced similar risks of mortality compared with those in 2019. After adjustment, patients with HF in 2020 and 2021 were less likely to experience all-cause hospitalizations (2020: rate ratio [RR], 0.88; 95% CI, 0.81-0.95; 2021: RR, 0.90; 95% CI, 0.83-0.97) compared with patients in 2019. Patients with HF in 2020 were also less likely to experience ED visits (RR, 0.85; 95% CI, 0.80-0.92).
In this large population-based study in southeastern Minnesota, we observed an approximately 10% decrease in hospitalizations among patients with HF in 2020 and 2021 and a 15% decrease in ED visits in 2020 compared with those in 2019. Despite the change in health care utilization, we found no difference in the 1-year mortality between patients with HF in 2020 and those in 2021 compared with those in 2019. It is unknown whether any longer-term consequences will be observed.
比较2019冠状病毒病（COVID-19）大流行之前及期间心力衰竭（HF）患者的1年医疗保健利用情况和死亡率。
确定明尼苏达州东南部9县地区在2019年1月1日、2020年1月1日和2021年1月1日年龄在18岁及以上且诊断为HF的居民，并对其进行为期1年的随访，以了解其生命状态、急诊就诊情况和住院情况。
我们在2019年1月1日确定了5631例HF患者（平均年龄76岁；53%为男性），2020年1月1日确定了5996例患者（平均年龄76岁；52%为男性），2021年1月1日确定了6162例患者（平均年龄75岁；54%为男性）。在对合并症和风险因素进行调整后，2020年的HF患者和2021年的HF患者与2019年的患者相比，死亡率风险相似。调整后，2020年和2021年的HF患者全因住院的可能性低于2019年的患者（2020年：率比[RR]，0.88；95%置信区间，0.81 - 0.95；2021年：RR，0.90；95%置信区间，0.83 - 0.97）。2020年的HF患者急诊就诊的可能性也较低（RR，0.85；95%置信区间，0.80 - 0.92）。
在明尼苏达州东南部这项基于人群的大型研究中，我们观察到2020年和2021年HF患者的住院率比2019年下降了约10%，2020年的急诊就诊率比2019年下降了15%。尽管医疗保健利用情况有所变化，但我们发现2020年的HF患者和2021年的HF患者与2019年的患者相比，1年死亡率没有差异。是否会观察到任何长期后果尚不清楚。
