Copyright © 1998 by the European Society of Cardiology.
Influence of concomitant disease on patterns of hospitalization in patients with heart failure discharged from Scottish hospitals in 1995
MRC Clinical Research Initiative in Heart Failure, University of Glasgow, Glasgow, Scotland, U.K.
accepted November 21, 1997
Aims
To determine the prevalence of common, serious, concomitant conditions complicating admissions with heart failure and how such conditions influence the length of hospital stay.
Methods and Results
Data from Scottish morbidity records (SMR1) were used to determine the rate of deaths and discharges for heart failure (ICD-9 428.0, 428.1, 428.9), concomitant discharge diagnoses and length of stay in 1995. 27477 SMR1 records listing heart failure as a diagnosis were identified with heart failure in the first position in 11560 (42%) records. 63·3% of deaths or discharges resulted from emergency admissions. 13·2% of admissions were associated with acute myocardial infarction, 7·3% with angina or chest pain, 11·8% with chronic airways obstruction, 8·3% with chronic or acute renal failure and 5·3% had had a stroke. Length of stay including those patients who died was 7·6 days when acute myocardial infarction was the principal diagnosis but 26·3 days when stroke was the principal diagnosis.
Conclusion
A large proportion of deaths and discharges for heart failure are associated with conditions other than heart failure that may precipitate, contribute to or complicate admission. Treatment for heart failure that does not also seek to reduce the risk associated with common concomitant diseases may miss opportunities to reduce the overall risk of hospitalization.
Key Words: Heart failure • concomitant diagnosis • hospital deaths and discharges • resource use • health economics
f1 Correspondence: Dr John G. F. Cleland, British Heart Foundation Senior Fellow, Medical Research Council Clinical Research Initiative in Heart Failure, West Medical Building, University of Glasgow, Glasgow G12 8QQ, Scotland, U.K.
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