Hospitalization of patients with heart failure: National Hospital Discharge Survey, 1985 to 1995

Background In the United States, heart failure has emerged as the leading f irst-listed diagnosis among hospitalized older adults. Methods The number and prevalence of hospitalizations, procedure use, and d ischarge outcomes for men and women aged greater than or equal to 35 years hospitalized with heart failure were estimated from National Hospital Disch arge Survey data for the years 1985 through 1995. Results In 10 years, the number of hospitalizations increased from 577,000 to 871,000 for a first-listed diagnosis and from 1.7 to 2.6 million for any diagnosis of heart Failure. Almost 78% of men and 85% of women hospitalize d with heart failure were aged greater than or equal to 65 years. Among per sons hospitalized with any diagnosis of heart failure, in-hospital mortalit y rate decreased from 1985 to 1995 whereas prevalence of discharge to long- term care increased. In 1995, 67% of male patients were discharged home, 12 % were discharged to long-term care, and 8% died during hospitalization; th e corresponding values for female patients were 58%, 21%, and 8%. Men had t wice the prevalence of invasive cardiac procedures as did women during hosp italization. Conclusions The growing burden of heart failure can be expected to increase during the next decade unless innovative interventions and primary and sec ondary prevention strategies are implemented.