Abstract 3103: A New Epidemic of Heart Failure in the United States: Findings from the National Hospital Discharge Surveys, 1980–2006

Abstract

Introduction: The most common diagnosis in hospitalized patients aged 65 or older is heart failure (HF). The study aimed to assess the hypothesis that HF hospitalization rates increased significantly in the last 27 years. Methods: Data from National Hospital Discharge Surveys (NHDS) between 1980 and 2006 was analyzed in depth. The NHDS was conducted with a multi-stage cross-sectional study design. HF was diagnosed according to ICD 9 th - CM version. It was then listed from first to seven diagnosis of HF. In the present study, patients with first-listed diagnosis of HF were defined as cases. Census estimated population data were used to estimate age and gender-specific hospitalization rates. Linear and multivariate Poisson regression analysis methods were used to estimate the long-term trend and relative risk of HF hospitalization by age, sex and time periods. Results: A total of 2,225,205 patients aged 65 or older were included in the study. Age-adjusted HF hospitalization rates significantly increased from 1980 to 2006, with an estimated annual percentage increase rates (95%CI) of 1.20% (0.76% ~ 3.17%) in men and of 1.55% (0.42% ~ 3.51%) in women. Poisson regression models indicate that the relative risk (95%CI) of being hospitalized due to HF in subjects living in the last 5-years of period (2002– 06) was 1.37 times higher (95%CI: 1.31 ~ 1.42) than those living in the early years of 1980 – 84. Subjects aged 85+ had 4 times higher risk of being hospitalization due to HF as compared to those aged 65–74. Furthermore, among three major forms of cardiovascular disease (CHD, stroke and HF), HF was the only disease showing a significantly increasing in the recent decades. In conclusion, the study for the first time documents the last 27 years trend of HF hospitalization rates among the elderly. It suggests that effective prevention strategies are urgently needed to control the unfavorable new epidemic of the disease.