Fifteen-year evolving trends of etiology and prognosis in hospitalized patients with heart failure
10.3760/cma.j.issn.0253-3758.2011.05.012
- VernacularTitle:慢性心力衰竭住院患者病因学及近期预后的15年变迁
- Author:
Zhi-Yong PEI
1
;
Yu-Sheng ZHAO
;
Jia-Yue LI
;
Qiao XUE
;
Lei GAO
;
Shi-Wen WANG
Author Information
1. 解放军北京军区总医院
- Keywords:
Heart failure,congestive;
Mortality;
Prognosis
- From:
Chinese Journal of Cardiology
2011;39(5):434-439
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiological and prognostic changes of hospitalized patients with chronic heart failure.Methods This retrospective study analyzed 7319 hospitalized patients (male 62.07%)with validated primary discharge diagnosis of chronic heart failure in Chinese PLA General Hospital in Beijing from January 1,1993 to December 31,2007.Etiological characteristics,comorbidities and 30-day hospitalized mortality in the following three periods:1993-1997(n=1623),1998-2002 (n=2444),and 2003-2007(n=3252)were compared.Results (1) The patient age increased[(56.0 ±17. 5) years, (57. 8 ± 17.6) years and (62. 7 ± 15.5) years, P <0. 01 ] and hospital stay time decreased [ (31.3 ± 17.4) days, (22. 7 ± 14. 1 ) days and (20. 1 ± 15.2) days, P <0. O1 ] from 1993 to 2007. (2)The common causes of heart failure were coronary heart disease, hypertension, rheumatic valvular heart disease and diabetes mellitus. From 1993 - 1998 to 2003 -2007, the proportion of patients with coronary heart disease,hypertension and diabetes mellitus rose from 37. 2% ,23.3% and 12. 3% to 46. 8%, 46. 7%and 21.1%, respectively (all P < 0. 05 ). Meanwhile the proportion of patients with rheumatic valvular heart disease fell from 35.2% to 16. 6% (P < 0. 05 ). (3) The main etiologies and comorbidities were atrial fibrillation, myocardial infarction, pneumonia, chronic obstructive pulmonary disease and renal failure.From 1993 -1998 to 2003 -2007, atrial fibrillation was the most common cause of heart failure, and the rate of myocardial infarction,pneumonia and renal failure rose from 11.0% ,8. 9% and 5.2% to 14. 7% ,14.5 % and 9. 1%, respectively ( all P < 0. 05 ) and the rate of COPD fell from 12. 9% to 8. 4% ( P < 0. 05 ).(4) The 30-day hospitalized mortalities in the three periods were 7.0% 、4. 5% and 5. 1%, respectively,and the mortalities in the 1998 -2002 and 2003 -2007 periods were lower than those of in the 1993 -1998period( all P < 0. 05 ). The mortality related to coronary heart disease decreased significantly from 1993 to 2007 ( 9. 3%, 5.0% and 3.8% in the three periods, respectively, P < 0. 05 ) . Conclusions It is demonstrated that the primary diseases causing heart failure were coronary heart disease, hypertension,diabetes mellitus and rheumatic valvular heart disease, and the former three diseases exhibited a upward trend and the later one exhibited a downward trend. Moreover, the proportion of comorhidities in patients with heart failure increased over the study period. The 30-day hospital mortality exhibited a downward trend and decreased significantly in patients with coronary heart disease or myocardial infarction.
