Burden and Timing of Hospitalizations in Heart Failure: A Community Study

Alanna M. Chamberlain*, Shannon M. Dunlay, Yariv Gerber, Sheila M. Manemann, Ruoxiang Jiang, Susan A. Weston, Véronique L. Roger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objective To study the temporal distribution and causes of hospitalizations after heart failure (HF) diagnosis. Patients and Methods Hospitalizations were studied in 1972 Olmsted County, Minnesota, residents with incident HF from January 1, 2000, to December 31, 2011. All hospitalizations were examined for the 2 years following incident HF, and each was categorized as due to HF, other cardiovascular causes, or noncardiovascular causes. Negative binomial regression examined associations between time periods (0-30, 31-182, 183-365, and 366-730 days after diagnosis) and hospitalizations. Results During the 2 years after diagnosis, 3495 hospitalizations were observed among 1336 of the 1972 patients with HF. The age- and sex-adjusted rates of hospitalizations were highest in the first 30 days after diagnosis (3.33 per person-year vs 1.33, 1.07, and 1.00 per person-year for 31-182 days, 183-365 days, and 366-730 days, respectively). The rates of hospitalizations were similar across sex, presentation of HF (inpatient or outpatient), and type of HF (preserved or reduced ejection fraction). Patients diagnosed as inpatients who had long hospital stays (>5 days) experienced more than a 30% increased risk of rehospitalization within 30 days of dismissal. Importantly, most hospitalizations (2222 of 3495 [63.6%]) were due to noncardiovascular causes, and a minority (440 of 3495 [12.6%]) were due to HF. The rates of noncardiovascular hospitalizations were higher than those for HF or other cardiovascular hospitalizations across all follow-up for all time periods after HF. Conclusion Patients with HF experience high rates of hospitalizations, particularly within the first 30 days, and mostly for noncardiovascular causes. To reduce hospitalizations in patients with HF, an integrated approach focusing on comorbidities is required.

Original languageEnglish
Pages (from-to)184-192
Number of pages9
JournalMayo Clinic Proceedings
Volume92
Issue number2
DOIs
StatePublished - 1 Feb 2017

Funding

FundersFunder number
Rochester Epidemiology ProjectR01-AG034676, R01 HL120859, R21 AG045228
National Institutes of Health
National Institute on AgingR21AG045228
Mayo Clinic
National Center for Advancing Translational Sciences

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