First hospitalization for heart failure in France in 2009: patient characteristics and 30-day follow-up
Philippe Tuppin, Anne Cuerq, Christine de Peretti, Anne Fagot-Campagna, Nicolas Danchin, Yves Juillière, François Alla, Hubert Allemand, Christophe Bauters, Milou-Daniel Drici, Albert Hagège, Guillaume Jondeau, Patrick Jourdain, Alain Leizorovicz, Fred Paccaud, Philippe Tuppin, Anne Cuerq, Christine de Peretti, Anne Fagot-Campagna, Nicolas Danchin, Yves Juillière, François Alla, Hubert Allemand, Christophe Bauters, Milou-Daniel Drici, Albert Hagège, Guillaume Jondeau, Patrick Jourdain, Alain Leizorovicz, Fred Paccaud
Abstract
Background: The incidence of heart failure (HF) is stable in industrialized countries, but its prevalence continues to increase, especially due to the ageing of the population, and mortality remains high.
Objective: To estimate the incidence in France and describe the management and short-term outcome of patients hospitalized for HF for the first time.
Method: The study population comprised French national health insurance general scheme beneficiaries (77% of the French population) hospitalized in 2009 with a principal diagnosis of HF after exclusion of those hospitalized for HF between 2006 and 2008 or with a chronic disease status for HF. 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 included. The incidence of first hospitalization for HF was 0.14% (≥ 55 years, 0.5%; ≥ 90 years, 3.1%). Compared with controls without HF, patients more frequently presented cardiovascular or other co-morbidities. The hospital mortality rate was 6.4% and the mortality rate during the 30 days after discharge was 4.4% (3.4% without readmission). Among 30-day survivors, all-cause and HF 30-day readmission rates were 18% (< 70 years, 22%; ≥ 90 years, 13%) and 5%, respectively. Reimbursements among 30-day survivors comprised at least a beta-blocker in 54% of cases, diuretics in 85%, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in 67%, a diuretic and ACEI/ARB combination in 23% and a beta-blocker, ACEI/ARB and diuretic combination in 37%.
Conclusion: Patients admitted for HF presented high rates of co-morbidity, readmission and death at 30 days, and there remains room for improvement in their drug treatments; these findings indicate the need for improvement in return-home and therapeutic education programmes.
Keywords: ACEI; AD; ALD; ARB; BNP; France; HF; Heart failure; Hospitalisation; Hospitalization; ICD 10; Incidence; Insuffisance cardiaque; International Classification of Diseases; PD; RR; SLM; SNIIRAM; Système National d’Information Inter-Régimes de l’Assurance Maladie; affections de longue durée; angiotensin II receptor blocker; angiotensin-converting enzyme inhibitor; associated diagnosis; brain natriuretic peptide; heart failure; local mutualist sections; principal diagnosis; relative risk.
Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Source: PubMed