Long-term survival and life expectancy following an acute heart failure hospitalization in Australia and New Zealand
© 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology..
AIMS: Contemporary long-term survival following a heart failure (HF) hospitalization is uncertain. We evaluated survival up to 10 years after a HF hospitalization using national data from Australia and New Zealand, identified predictors of survival, and estimated the attributable loss in life expectancy.
METHODS AND RESULTS: Patients hospitalized with a primary diagnosis of HF from 2008-2017 were identified and all-cause mortality assessed by linking with Death Registries. Flexible parametric survival models were used to estimate survival, predictors of survival and loss in life expectancy. A total of 283 048 patients with HF were included (mean age 78.2 ± 12.3 years, 50.8% male). Of these, 48.3% (48.1-48.5) were surviving by 3 years, 34.1% (33.9-34.3) by 5 years and 17.1% (16.8-17.4) by 10 years (median survival 2.8 years). Survival declined with age with 53.4% of patients aged 18-54 years and 6.2% aged ≥85 years alive by 10 years (adjusted hazard ratio [aHR] for mortality 4.84, 95% confidence interval [CI] 4.65-5.04 for ≥85 years vs. 18-54 years) and was worse in male patients (aHR 1.14, 95% CI 1.13-1.15). Prior HF (aHR 1.20, 95% CI 1.18-1.22), valvular and rheumatic heart disease (aHR 1.11, 95% CI 1.10-1.13) and vascular disease (aHR 1.07, 95% CI 1.04-1.09) were cardiovascular comorbidities most strongly associated with long-term death. Non-cardiovascular comorbidities and geriatric syndromes were common and associated with higher mortality. Compared with the general population, HF was associated with a loss of 7.3 years in life expectancy (or 56.6% of the expected life expectancy) and reached 20.5 years for those aged 18-54 years.
CONCLUSION: Less than one in five patients hospitalized for HF were surviving by 10 years with patients experiencing almost 60% loss in life expectancy compared with the general population, highlighting the considerable persisting societal burden of HF. Concerted multidisciplinary efforts are needed to improve post-hospitalization outcomes of HF.
| Errataetall: |
CommentIn: Eur J Heart Fail. 2022 Sep;24(9):1529-1531. - PMID 35918910 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
European journal of heart failure - 24(2022), 9 vom: 15. Sept., Seite 1519-1528 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hariharaputhiran, Saranya [VerfasserIn] |
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| Links: |
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| Themen: |
Heart failure |
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| Anmerkungen: |
Date Completed 11.10.2022 Date Revised 04.01.2023 published: Print-Electronic CommentIn: Eur J Heart Fail. 2022 Sep;24(9):1529-1531. - PMID 35918910 Citation Status MEDLINE |
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| doi: |
10.1002/ejhf.2595 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342691910 |
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| 100 | 1 | |a Hariharaputhiran, Saranya |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term survival and life expectancy following an acute heart failure hospitalization in Australia and New Zealand |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 11.10.2022 | ||
| 500 | |a Date Revised 04.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Eur J Heart Fail. 2022 Sep;24(9):1529-1531. - PMID 35918910 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. | ||
| 520 | |a AIMS: Contemporary long-term survival following a heart failure (HF) hospitalization is uncertain. We evaluated survival up to 10 years after a HF hospitalization using national data from Australia and New Zealand, identified predictors of survival, and estimated the attributable loss in life expectancy | ||
| 520 | |a METHODS AND RESULTS: Patients hospitalized with a primary diagnosis of HF from 2008-2017 were identified and all-cause mortality assessed by linking with Death Registries. Flexible parametric survival models were used to estimate survival, predictors of survival and loss in life expectancy. A total of 283 048 patients with HF were included (mean age 78.2 ± 12.3 years, 50.8% male). Of these, 48.3% (48.1-48.5) were surviving by 3 years, 34.1% (33.9-34.3) by 5 years and 17.1% (16.8-17.4) by 10 years (median survival 2.8 years). Survival declined with age with 53.4% of patients aged 18-54 years and 6.2% aged ≥85 years alive by 10 years (adjusted hazard ratio [aHR] for mortality 4.84, 95% confidence interval [CI] 4.65-5.04 for ≥85 years vs. 18-54 years) and was worse in male patients (aHR 1.14, 95% CI 1.13-1.15). Prior HF (aHR 1.20, 95% CI 1.18-1.22), valvular and rheumatic heart disease (aHR 1.11, 95% CI 1.10-1.13) and vascular disease (aHR 1.07, 95% CI 1.04-1.09) were cardiovascular comorbidities most strongly associated with long-term death. Non-cardiovascular comorbidities and geriatric syndromes were common and associated with higher mortality. Compared with the general population, HF was associated with a loss of 7.3 years in life expectancy (or 56.6% of the expected life expectancy) and reached 20.5 years for those aged 18-54 years | ||
| 520 | |a CONCLUSION: Less than one in five patients hospitalized for HF were surviving by 10 years with patients experiencing almost 60% loss in life expectancy compared with the general population, highlighting the considerable persisting societal burden of HF. Concerted multidisciplinary efforts are needed to improve post-hospitalization outcomes of HF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Hospitalizations | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Survival | |
| 700 | 1 | |a Peng, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Ngo, Linh |e verfasserin |4 aut | |
| 700 | 1 | |a Ali, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Hossain, Sadia |e verfasserin |4 aut | |
| 700 | 1 | |a Visvanathan, Renuka |e verfasserin |4 aut | |
| 700 | 1 | |a Adams, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Wandy |e verfasserin |4 aut | |
| 700 | 1 | |a Ranasinghe, Isuru |e verfasserin |4 aut | |
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