National trends in admission and in-hospital mortality of patients with heart failure in the United States (2001-2014)

Emmanuel Akintoye, Alexandros Briasoulis, Alexander Egbe, Shannon M Dunlay, Sudhir Kushwaha, Diane Levine, Luis Afonso, Dariush Mozaffarian, Jarrett Weinberger

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background--To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines. Methods and Results--Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95% confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2.5%-3.5%) and 3.5% (2.9%-4.0%), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions was more in 2006 to 2009 (ie, 3.4% versus 1.1%; P=0.02). In 2010 to 2014, primary HF admission continued to decline by an average annual rate of 4.3% (95% confidence interval, 3.9%-5.1%), but this was not significantly different from 2006 to 2009 (P=0.14). In contrast, there was no further decline in in-hospital mortality trend after the guideline-release years. For hospitalizations with HF as the secondary diagnosis, there was an upward trend in admissions in 2001 to 2005. However, the trend began to decline in 2006 to 2009, with an average annual rate of 2.4% (95% confidence interval, 0.8%-4%). Meanwhile, there was a consistent decline in in-hospital mortality by an average annual rate of 3.7% (95% confidence interval, 3.3%-4.2%) during the study period, but the decline was more in 2006 to 2009 compared with 2001 to 2005 (ie, 5.4% versus 3.4%; P < 0.001). Beyond 2009, admission and in-hospital mortality rates continued to decline, although this was not significantly better than the preceding interval. Conclusions--From 2001 to 2014, HF admission and in-hospital mortality rates declined significantly in the United States; the greatest improvements coincided with the publication of the 2005 American College of Cardiology/American Heart Association HF guidelines.

Original languageEnglish (US)
Article numbere006955
JournalJournal of the American Heart Association
Volume6
Issue number12
DOIs
StatePublished - Dec 1 2017

Fingerprint

Hospital Mortality
Heart Failure
Confidence Intervals
Hospitalization
Guidelines
Publications
Mortality
Censuses
Inpatients

Keywords

  • Heart failure
  • Hospitalization
  • Mortality
  • Outcome
  • Quality of care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

National trends in admission and in-hospital mortality of patients with heart failure in the United States (2001-2014). / Akintoye, Emmanuel; Briasoulis, Alexandros; Egbe, Alexander; Dunlay, Shannon M; Kushwaha, Sudhir; Levine, Diane; Afonso, Luis; Mozaffarian, Dariush; Weinberger, Jarrett.

In: Journal of the American Heart Association, Vol. 6, No. 12, e006955, 01.12.2017.

Research output: Contribution to journalArticle

Akintoye, Emmanuel ; Briasoulis, Alexandros ; Egbe, Alexander ; Dunlay, Shannon M ; Kushwaha, Sudhir ; Levine, Diane ; Afonso, Luis ; Mozaffarian, Dariush ; Weinberger, Jarrett. / National trends in admission and in-hospital mortality of patients with heart failure in the United States (2001-2014). In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 12.
@article{77bb35bba1b640bb8398915342ba0dd1,
title = "National trends in admission and in-hospital mortality of patients with heart failure in the United States (2001-2014)",
abstract = "Background--To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines. Methods and Results--Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95{\%} confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3{\%} (2.5{\%}-3.5{\%}) and 3.5{\%} (2.9{\%}-4.0{\%}), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions was more in 2006 to 2009 (ie, 3.4{\%} versus 1.1{\%}; P=0.02). In 2010 to 2014, primary HF admission continued to decline by an average annual rate of 4.3{\%} (95{\%} confidence interval, 3.9{\%}-5.1{\%}), but this was not significantly different from 2006 to 2009 (P=0.14). In contrast, there was no further decline in in-hospital mortality trend after the guideline-release years. For hospitalizations with HF as the secondary diagnosis, there was an upward trend in admissions in 2001 to 2005. However, the trend began to decline in 2006 to 2009, with an average annual rate of 2.4{\%} (95{\%} confidence interval, 0.8{\%}-4{\%}). Meanwhile, there was a consistent decline in in-hospital mortality by an average annual rate of 3.7{\%} (95{\%} confidence interval, 3.3{\%}-4.2{\%}) during the study period, but the decline was more in 2006 to 2009 compared with 2001 to 2005 (ie, 5.4{\%} versus 3.4{\%}; P < 0.001). Beyond 2009, admission and in-hospital mortality rates continued to decline, although this was not significantly better than the preceding interval. Conclusions--From 2001 to 2014, HF admission and in-hospital mortality rates declined significantly in the United States; the greatest improvements coincided with the publication of the 2005 American College of Cardiology/American Heart Association HF guidelines.",
keywords = "Heart failure, Hospitalization, Mortality, Outcome, Quality of care",
author = "Emmanuel Akintoye and Alexandros Briasoulis and Alexander Egbe and Dunlay, {Shannon M} and Sudhir Kushwaha and Diane Levine and Luis Afonso and Dariush Mozaffarian and Jarrett Weinberger",
year = "2017",
month = "12",
day = "1",
doi = "10.1161/JAHA.117.006955",
language = "English (US)",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - National trends in admission and in-hospital mortality of patients with heart failure in the United States (2001-2014)

AU - Akintoye, Emmanuel

AU - Briasoulis, Alexandros

AU - Egbe, Alexander

AU - Dunlay, Shannon M

AU - Kushwaha, Sudhir

AU - Levine, Diane

AU - Afonso, Luis

AU - Mozaffarian, Dariush

AU - Weinberger, Jarrett

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background--To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines. Methods and Results--Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95% confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2.5%-3.5%) and 3.5% (2.9%-4.0%), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions was more in 2006 to 2009 (ie, 3.4% versus 1.1%; P=0.02). In 2010 to 2014, primary HF admission continued to decline by an average annual rate of 4.3% (95% confidence interval, 3.9%-5.1%), but this was not significantly different from 2006 to 2009 (P=0.14). In contrast, there was no further decline in in-hospital mortality trend after the guideline-release years. For hospitalizations with HF as the secondary diagnosis, there was an upward trend in admissions in 2001 to 2005. However, the trend began to decline in 2006 to 2009, with an average annual rate of 2.4% (95% confidence interval, 0.8%-4%). Meanwhile, there was a consistent decline in in-hospital mortality by an average annual rate of 3.7% (95% confidence interval, 3.3%-4.2%) during the study period, but the decline was more in 2006 to 2009 compared with 2001 to 2005 (ie, 5.4% versus 3.4%; P < 0.001). Beyond 2009, admission and in-hospital mortality rates continued to decline, although this was not significantly better than the preceding interval. Conclusions--From 2001 to 2014, HF admission and in-hospital mortality rates declined significantly in the United States; the greatest improvements coincided with the publication of the 2005 American College of Cardiology/American Heart Association HF guidelines.

AB - Background--To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines. Methods and Results--Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95% confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2.5%-3.5%) and 3.5% (2.9%-4.0%), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions was more in 2006 to 2009 (ie, 3.4% versus 1.1%; P=0.02). In 2010 to 2014, primary HF admission continued to decline by an average annual rate of 4.3% (95% confidence interval, 3.9%-5.1%), but this was not significantly different from 2006 to 2009 (P=0.14). In contrast, there was no further decline in in-hospital mortality trend after the guideline-release years. For hospitalizations with HF as the secondary diagnosis, there was an upward trend in admissions in 2001 to 2005. However, the trend began to decline in 2006 to 2009, with an average annual rate of 2.4% (95% confidence interval, 0.8%-4%). Meanwhile, there was a consistent decline in in-hospital mortality by an average annual rate of 3.7% (95% confidence interval, 3.3%-4.2%) during the study period, but the decline was more in 2006 to 2009 compared with 2001 to 2005 (ie, 5.4% versus 3.4%; P < 0.001). Beyond 2009, admission and in-hospital mortality rates continued to decline, although this was not significantly better than the preceding interval. Conclusions--From 2001 to 2014, HF admission and in-hospital mortality rates declined significantly in the United States; the greatest improvements coincided with the publication of the 2005 American College of Cardiology/American Heart Association HF guidelines.

KW - Heart failure

KW - Hospitalization

KW - Mortality

KW - Outcome

KW - Quality of care

UR - http://www.scopus.com/inward/record.url?scp=85038844937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038844937&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.006955

DO - 10.1161/JAHA.117.006955

M3 - Article

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 12

M1 - e006955

ER -