Trends and complications associated with acute new-onset heart failure: a National Readmissions Database–based cohort study,Heart Failure Reviews

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Trends and complications associated with acute new-onset heart failure: a National Readmissions Database–based cohort study
Heart Failure Reviews ( IF 4.5 ) Pub Date : 2021-07-28 , DOI: 10.1007/s10741-021-10152-3
Tanveer Mir ₁ , Mohammed Uddin ₁ , Waqas T Qureshi ₂ , Layla Shanah ₁ , Ayman Soubani ₁ , Ghulam Saydain ₁ , Luis Afonso ₁ , Sheikh Mujeeb ₃

Affiliation

Literature regarding recent trends and outcomes of acute new-onset heart failure (AHF) with preserved ejection fraction (AHFpEF) and reduced ejection fraction (AHFrEF) is limited. The objective of this study is to study the outcomes of AHFpEF and AHFrEF in the USA. Data from the National Readmissions Database (NRD) sample that constitutes 49.1% of the stratified sample of all hospitals in the USA, representing more than 95% of the national population, were analyzed for hospitalization visits for acute heart failure. ICD-9 and ICD-10 codes were used to identify AHF. A total of 2,559,102 adult index AHF patients (mean age 70.79 ± 14.58 years, 49.4% females), 1,028,970 (40.2%) AHFpEF and 1,330,999 (52%) AHFrEF, were recorded in the National Readmissions Database for the years 2016–2018. A total of 152,465 (5.96%) acute heart failure, 47,271 (4.6%) AHFpEF and 91,973 (6.91%) AHFrEF, died during hospitalization, and 45,810 (1.9%) were readmitted in 30 days among alive discharges. Higher complication rates which included ventricular arrhythmias, acute coronary, and cerebrovascular events were observed among AHFrEF than AHFpEF. Higher proportion of patients with AHFrEF needed intensive care unit and ventilatory support during the hospitalization. The trend of incidence of AHFrEF, mortality among AHFrEF, and overall mortality worsened while AHFpEF improved over the study years 2012–2018 (p-trend < 0.05). Coronary procedures improved mortality rates among AHFpEF and AHFrEF. AHF is very common and is associated with significant mortality. The incidence of AHFrEF and mortality among AHFrEF had worsened, which calls for urgent intervention. Improved recognition of AHF is needed, and guideline-directed treatment of underlying risk factors including coronary artery disease can improve mortality.

Graphical abstract

Graphic abstract of the analysis presented (created with BioRender.com)

中文翻译：

与急性新发心力衰竭相关的趋势和并发症：基于国家再入院数据库的队列研究

关于射血分数保留 (AHFpEF) 和射血分数降低 (AHFrEF) 的急性新发心力衰竭 (AHF) 的近期趋势和结果的文献有限。本研究的目的是研究美国 AHFpEF 和 AHFrEF 的结果。对来自全国再入院数据库 (NRD) 样本的数据进行了分析，该样本占美国所有医院分层样本的 49.1%，代表全国人口的 95% 以上，用于分析急性心力衰竭的住院就诊情况。ICD-9 和 ICD-10 代码用于识别 AHF。2016-2018 年国家再入院数据库记录了总共 2,559,102 名成人指数 AHF 患者（平均年龄 70.79 ± 14.58 岁，49.4% 女性）、1,028,970 名（40.2%）AHFpEF 和 1,330,999 名（52%）AHFrEF。共有 152,465 (5.96%) 例急性心力衰竭，47,271 (4. 6%) AHFpEF 和 91,973 (6.91%) AHFrEF 在住院期间死亡，45,810 (1.9%) 人在 30 天内重新入院。与 AHFpEF 相比，AHFrEF 的并发症发生率更高，包括室性心律失常、急性冠状动脉和脑血管事件。较高比例的 AHFrEF 患者在住院期间需要重症监护室和通气支持。在 2012-2018 年研究期间，AHFrEF 的发病率、AHFrEF 死亡率和总死亡率恶化，而 AHFpEF 有所改善（较高比例的 AHFrEF 患者在住院期间需要重症监护室和通气支持。在 2012-2018 年研究期间，AHFrEF 的发病率、AHFrEF 死亡率和总死亡率恶化，而 AHFpEF 有所改善（较高比例的 AHFrEF 患者在住院期间需要重症监护室和通气支持。在 2012-2018 年研究期间，AHFrEF 的发病率、AHFrEF 死亡率和总死亡率恶化，而 AHFpEF 有所改善（p趋势 < 0.05)。冠状动脉手术提高了 AHFpEF 和 AHFrEF 的死亡率。AHF 非常常见，并且与显着的死亡率相关。AHFrEF 中 AHFrEF 的发病率和死亡率已经恶化，需要紧急干预。需要提高对 AHF 的认识，对包括冠状动脉疾病在内的潜在危险因素进行指导性治疗可以提高死亡率。

图形概要

所呈现分析的图形摘要（由 BioRender.com 创建）

更新日期：2021-07-28

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