Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic
| Autor: | John G.F. Cleland, John E. Deanfield, Jianhua Wu, Mark A de Belder, Harriette G.C. Van Spall, Fozia Z Ahmed, Mamas A. Mamas, Theresa McDonagh, Ahmad Shoaib, Mohamed O. Mohamed, Chris P Gale, Muhammad Rashid |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Rate ratio Severity of Illness Index State Medicine RC705 Cause of Death Pandemic Hospitalisation medicine Electronic Health Records Humans AcademicSubjects/MED00200 Hospital Mortality Mortality Medical prescription Quality of Health Care Aged 80 and over Heart Failure Clinical Audit SARS-CoV-2 business.industry Health Policy Acute heart failure COVID-19 Odds ratio medicine.disease United Kingdom Confidence interval Hospitalization Heart failure Communicable Disease Control Emergency medicine Hospital admission Original Article Female Cardiology and Cardiovascular Medicine business RA |
| Zdroj: | European Heart Journal. Quality of Care & Clinical Outcomes |
| ISSN: | 2058-1742 2058-5225 |
| Popis: | Aims We hypothesized that a decline in admissions with heart failure during COVID-19 pandemic would lead to a reciprocal rise in mortality for patients with heart failure in the community. Methods and results We used National Heart Failure Audit data to identify 36 974 adults who had a hospital admission with a primary diagnosis of heart failure between February and May in either 2018, 2019, or 2020. Hospital admissions for heart failure in 2018/19 averaged 160/day but were much lower in 2020, reaching a nadir of 64/day on 27 March 2020 [incidence rate ratio (IRR): 0.40, 95% confidence interval (CI): 0.38–0.42]. The proportion discharged on guideline-recommended pharmacotherapies was similar in 2018/19 compared to the same period in 2020. Between 1 February–2020 and 31 May 2020, there was a 29% decrease in hospital deaths related to heart failure (IRR: 0.71, 95% CI: 0.67–0.75; estimated decline of 448 deaths), a 31% increase in heart failure deaths at home (IRR: 1.31, 95% CI: 1.24–1.39; estimated excess 539), and a 28% increase in heart failure deaths in care homes and hospices (IRR: 1.28, 95% CI: 1.18–1.40; estimated excess 189). All-cause, inpatient death was similar in the COVID-19 and pre-COVID-19 periods [odds ratio (OR): 1.02, 95% CI: 0.94–1.10]. After hospital discharge, 30-day mortality was higher in 2020 compared to 2018/19 (OR: 1.57, 95% CI: 1.38–1.78). Conclusion Compared with the rolling daily average in 2018/19, there was a substantial decline in admissions for heart failure but an increase in deaths from heart failure in the community. Despite similar rates of prescription of guideline-recommended therapy, mortality 30 days from discharge was higher during the COVID-19 pandemic period. |
| Databáze: | OpenAIRE |
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