Clinical InvestigationsTrends in hospitalizations for heart failure, acute myocardial infarction, and stroke in the United States from 2004 to 2018
Section snippets
Method
We conducted a retrospective analysis of discharge data from the National Inpatient Sample (NIS) between January 1, 2004 and December 31, 2018. The NIS is an all-payer database that approximates a 20% stratified sample of discharges from US community hospitals participating in the Healthcare Cost and Utilization Project (HCUP). It contains unweighted data from more than 7 million yearly hospital stays, and once weighted, estimates approximately 35 million stays. It includes deidentified
Results
Between 2004 and 2018, there were 33.4 million hospitalizations for HF, AMI, and stroke, with the most being for HF (48%).
Discussion
In this analysis of more than 33 million hospitalizations for HF, AMI, and stroke from 2004 to 2018, the main findings are: (1) Despite an initial decline, hospitalizations for HF have been increasing since 2013. This is in contrast to a decrease in the hospitalizations for AMI and a relatively small increase in the hospitalizations for stroke during 2004-2018. (2) Inpatient mortality for HF, AMI, and stroke has decreased over time.
Previous analyses showed a decline in hospitalizations for HF
Conclusion
HF hospitalizations constitute the majority of CV hospitalizations. Despite an initial decline in HF hospitalizations, a progressive increase occurred after 2013. This concerning trend is in contrast to the rates of hospitalization for AMI and stroke. In-hospital mortality decreased for HF, AMI, and stroke hospitalizations. Further investigations are needed to identify causes for the increasing rate of hospitalizations for HF since 2014 and potential interventions.
Disclosures
Dr Greene receives research support from the American Heart Association, Amgen, AstraZeneca, Bristol-Myers Squibb, Merck, and Novartis; serves on advisory boards for Amgen and Cytokinetics; and serves as a consultant for Amgen and Merck. Dr Ambrosy is supported by a Mentored Patient-Oriented Research Career Development Award (K23HL150159) through the National Heart, Lung, and Blood Institute, has received relevant research support through grants to his institution from Amarin Pharma, Inc,
Data availability statements
The data underlying this article are available in the National Inpatient Sample, at https://www.hcup-us.ahrq.gov/nisoverview.jsp.The datasets were derived from sources in the public domain: https://www.hcup-us.ahrq.gov/nisoverview.jsp.
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This paper was handled by Guest Editor (William S. Weintraub, MD. Clin. Inv.)