Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic.
Eur Heart J Qual Care Clin Outcomes
; 7(4): 378-387, 2021 07 21.
Article
in English
| MEDLINE | ID: covidwho-1246705
ABSTRACT
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 ANDRESULTS:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Communicable Disease Control
/
Hospital Mortality
/
COVID-19
/
Heart Failure
/
Hospitalization
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Eur Heart J Qual Care Clin Outcomes
Year:
2021
Document Type:
Article
Affiliation country:
Ehjqcco
Similar
MEDLINE
...
LILACS
LIS