Copyright © 2001 by the European Society of Cardiology.
Trends in hospitalization for heart failure in Scotland, 1990–1996. An epidemic that has reached its peak?
a The CRI in Heart Failure, University of Glasgow, Glasgow, Scotland
b Department of Public Health, University of Glasgow, Glasgow, Scotland
c Information and Statistics Division of the National Health Service in Scotland, Edinburgh, Scotland
d Department of Public Health, University of Liverpool, Liverpool, U.K.
revised May 22, 2000; accepted May 24, 2000
Abstract
Aims Studies in the 1980s and early 1990s showed striking increases in hospitalization rates for heart failure. This report describes contemporary trends in hospitalization for heart failure.
Methods Scotland (population of 5·1 million) has a well described system for recording details of all hospitalizations. All hospital discharges (and deaths) can be linked to each patient. We examined the period 1990–1996 (158989 hospitalizations with a principal or secondary diagnosis of heart failure).
Results Compared to 1990, the number of hospitalizations with a principal diagnosis of heart failure increased in men (by 16%) and women (by 12%), although the highest numbers were recorded in 1993 in women (21%) and in 1994 in men (24%). Similar trends were seen for the number of patients hospitalized overall and those having a ‘first ever’ hospitalization. Hospitalizations with a secondary diagnosis of heart failure increased much more strikingly (by 110% and 60% in men and women, respectively). Re-hospitalization became more common, increasing by 53% and representing 23% of all hospitalizations in 1996. Median length of stay fell (from 9 to 8 days in men and 13 to 10 days in women with a principal diagnosis of heart failure), resulting in 100877 fewer inpatient days. Heart failure (principal diagnosis) still, however, accounted for 4·2% of all inpatient medicine/geriatric bed-days in 1996. Although inpatient case fatality fell slightly, the total number of deaths due to heart failure (principal diagnosis) increased slightly.
Conclusions Heart failure continues to be a common cause of hospitalization. The previously reported ‘epidemic’ of increasing rates of hospitalization for heart failure in Scotland and elsewhere between 1980 and 1990, however, seems to have peaked (in about 1993/4).
Key Words: Heart failure, hospitalization, mortality, trends, epidemiology
f1 Correspondence: Professor John McMurray, CRI in Heart Failure, Wolfson Building, University of Glasgow, Glasgow G12 8QQ, U.K.
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