INFLUENCE OF CONCOMITANT DISEASE ON PATTERNS OF HOSPITALIZATION IN PATIENTS WITH HEART-FAILURE DISCHARGED FROM SCOTTISH HOSPITALS IN 1995

Aims To determine the prevalence of common, serious, concomitant condi tions complicating admissions with heart failure and how such conditio ns influence the length of hospital stay. Methods and Results Data fro m Scottish morbidity records (SMR1) were used to determine the rate of deaths and discharges for heart failure (ICD-9 428.0, 428.1, 428.9), concomitant discharge diagnoses and length of stay in 1995. 27 477 SMR 1 records listing heart failure as a diagnosis were identified with he art failure in the first position in 11 560 (42%) records. 63.3% of de aths or discharges resulted from emergency admissions. 13.2% of admiss ions were associated with acute myocardial infarction, 7.3% with angin a or chest pain, 11.8% with chronic airways obstruction, 8.3% with chr onic or acute renal failure and 5.3% had had a stroke. Length of stay including those patients who died was 7.6 days when acute myocardial i nfarction was the principal diagnosis but 26.3 days when stroke was th e principal diagnosis. Conclusion A large proportion of deaths and dis charges for heart failure are associated with conditions other than he art failure that may precipitate, contribute to or complicate admissio n. Treatment for heart failure that does not also seek to reduce the r isk associated with common concomitant diseases may miss opportunities to reduce the overall risk of hospitalization.