Real world heart failure epidemiology and outcome: A population-based analysis of 88,195 patients

PLoS One. 2017 Feb 24;12(2):e0172745. doi: 10.1371/journal.pone.0172745. eCollection 2017.

Abstract

Background: Heart failure (HF) is frequent and its prevalence is increasing. We aimed to evaluate the epidemiologic features of HF patients, the 1-year follow-up outcomes and the independent predictors of those outcomes at a population level.

Methods and results: Population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on December 31st, 2012. Patients were divided in 3 groups: patients without a previous HF hospitalization, patients with a remote (>1 year) HF hospitalization and patients with a recent (<1 year) HF admission. We analyzed 1year all-cause and HF hospitalizations, and all-cause mortality. Logistic regression was used to identify the independent predictors of each of those outcomes. A total of 88,195 patients were included. Mean age was 77 years, 55% were women. Comorbidities were frequent. Fourteen percent of patients had never been hospitalized, 71% had a remote HF hospitalization and 15% a recent hospitalization. At 1-year follow-up, all-cause and HF hospitalization were 53% and 8.8%, respectively. One-year all-cause mortality rate was 14%, and was higher in patients with a recent HF hospitalization (24%). The presence of diabetes mellitus, atrial fibrillation or chronic kidney disease was independently associated with all-cause and HF hospitalization and all-cause mortality. Hospital admissions and emergency department visits the previous year were also found to be independently associated with the three study outcomes.

Conclusions: Outcomes are different depending on the HF population studied. Some comorbidity, an all-cause hospitalization or emergency department visit the previous year were associated with a worse outcome.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / physiopathology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / physiopathology
  • Emergency Medicine
  • Female
  • Follow-Up Studies
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / physiopathology
  • Spain / epidemiology

Grants and funding

Miguel Cainzos-Achirica was funded by a research grant from the Spanish Society of Cardiology.