alexa Two-year outcome of patients after a first hospitalization for heart failure: A national observational study.


Journal of Community Medicine & Health Education

Author(s): Tuppin P, Cuerq A, de Peretti C, FagotCampagna A, Danchin N,

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Abstract BACKGROUND: National population-based management and outcome data for patients of all ages hospitalized for heart failure have rarely been reported. AIM: National population-based management and outcome of patients of all ages hospitalized for heart failure have rarely been reported. The present study reports these results, based on 77\% of the French population, for patients hospitalized for the first time for heart failure in 2009. METHODS: The study population comprised French national health insurance general scheme beneficiaries hospitalized in 2009 with a principal diagnosis of heart failure, after exclusion of those hospitalized for heart failure between 2006 and 2008 or with a chronic disease status for heart failure. Data were collected from the national health insurance information system (SNIIRAM). RESULTS: A total of 69,958 patients (mean age, 78 years; 48\% men) were studied. The hospital mortality rate was 6.4\%, with 1-month, 1-year and 2-year survival rates of 89\%, 71\% and 60\%, respectively. Heart failure and all-cause readmission-free rates were 55\% and 43\% at 1 year and 27\% and 17\% at 2 years, respectively. Compared with a reference sample of 600,000 subjects, the age- and sex-standardized relative risk of death was 29 (95\% confidence interval [CI] 28-29) at 2 years, 82 (95\% CI 72-94) in subjects aged<50 years and 3 (95\% CI 3-3) in subjects aged ≥ 90 years. For subjects aged < 70 years who survived 1 month after discharge, factors associated with a reduction in the 2-year mortality rate were: female sex; age < 55 years; absence of co-morbidities; and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, lipid-lowering agents or oral anticoagulants during the month following discharge. Poor prognostic factors were treatment with a loop diuretic before or after hospitalization and readmission for heart failure within 1 month after discharge. CONCLUSIONS: This large population-based study confirms the severe prognosis of heart failure and the need to promote the use of effective medications and management designed to improve survival. Copyright © 2014 Elsevier Masson SAS. All rights reserved. This article was published in Arch Cardiovasc Dis and referenced in Journal of Community Medicine & Health Education

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