McMurray J, McDonagh T, Morrison C E, Dargie H J
Department of Cardiology, Western Infirmary, Glasgow, Scotland, UK.
Eur Heart J. 1993 Sep;14(9):1158-62. doi: 10.1093/eurheartj/14.9.1158.
Heart failure is a growing public health problem in industrialized countries with ageing populations. Scotland has a relatively stable population of approximately 5 million and a well described system for recording details of hospitalizations (Scottish Hospital In-Patients Statistics-SHIPS). We have examined SHIPS data for hospitalizations for heart failure in Scotland 1980-1990. Discharges for heart failure as the primary diagnosis increased by almost 60%, from 1.30 to 2.12/1000 population in this period (as either primary or secondary diagnosis the rate increased from 2.51 to 4.24/1000). Seventy-eight percent of discharges were in persons aged > or = 65 years and 48% of discharges were male. Heart failure (primary diagnosis) accounted for almost 4% of all general (internal) medicine discharges. In-patient case fatality was 18% in 1990. Mean duration of in-patient stay on Internal Medicine wards was approximately 11 days. The number of hospitalizations for heart failure is now almost identical to those for myocardial infarction. These trends mirror those recently reported from the United States. Heart failure is an increasingly common and costly cause of hospitalization in Scotland. Approaches which can reduce this burden on the hospital service require urgent attention.
在人口老龄化的工业化国家，心力衰竭正成为一个日益严重的公共卫生问题。苏格兰人口相对稳定，约为500万，并且有一套完善的系统来记录住院详情（苏格兰医院住院患者统计数据 - SHIPS）。我们研究了1980 - 1990年苏格兰因心力衰竭住院的SHIPS数据。在此期间，以心力衰竭作为主要诊断的出院人数增加了近60%，从每1000人口中的1.30例增至2.12例（作为主要或次要诊断，该比率从每1000人口中的2.51例增至4.24例）。78%的出院患者年龄在65岁及以上，48%的出院患者为男性。心力衰竭（主要诊断）占所有普通（内科）医学出院人数的近4%。1990年住院患者病死率为18%。内科病房的平均住院时间约为11天。目前，心力衰竭的住院人数几乎与心肌梗死的住院人数相同。这些趋势与美国最近报道的情况相似。在苏格兰，心力衰竭是住院日益常见且成本高昂的原因。能够减轻医院服务负担的方法亟待关注。
