Clinical InvestigationCongestive Heart FailureRepeated hospitalizations predict mortality in the community population with heart failure
Section snippets
Data sources
We used health care utilization databases that contain information on discharge abstract, outpatient diagnoses, and procedure codes for all residents of British Columbia, Canada, from 1996 to 2004, where the Canadian national insurance system provides comprehensive coverage for health care for all including the elderly and disabled. These data sources provide basic demographic information, as well as coded diagnostic, procedural, and pharmacy dispensing information with high accuracy.12 The
Study population and its characteristics
We identified a cohort of 14,374 patients who were hospitalized for HF for the first time during January 1, 2000, to December 31, 2004. Characteristics of the study population are summarized in Table I. The mean age of the cohort was >75 years, reflecting the high incidence of HF in the elderly population. Patients had a high prevalence of comorbid conditions, including other cardiovascular diseases, diabetes, chronic pulmonary diseases, and CKD. Of 14,374 patients, 3,358 patients had second,
Discussion
Among 14,374 patients with repeated HF hospitalizations, mortality increased sharply with recurrent HF hospitalizations. The number of repeated HF hospitalizations remained a strong independent predictor of mortality even after adjusting for other major risk factors for mortality among HF patients. However, the effects of the number of repeated HF hospitalizations were diminished with advanced age, presence of CKD, and history of cardiac arrest.
History and timing of prior HF hospitalization
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This project was supported by grants from the National Institute on Aging (R01-AG021950) and from the Agency for Healthcare Research and Quality (2-RO1-HS10881), Department of Health and Human Services, Rockville, MD.