A population-based study on overt heart failure in Lombardy (survey of hospitalization in 1996 and 1997).
BACKGROUND
The aim of this study was to get updated information about the incidence and outcome of heart failure hospital admission in the whole population of the largest Italy region.


METHODS
The Lombardy regional database of hospital records (Information System and Quality Control Bureau) provided the requested information: all the heart failure cases admitted to all the institutions of the region were selected by the ICD9 code of congestive heart failure (428-) as the principal or secondary diagnosis. The available data included: diagnosis and surgical procedures (up to four), date of birth, dates of admission and discharge, outcome, DRG code, discharge unit code, gender. The data so obtained concern the hospital discharges in 1996 and 1997.


RESULTS
32,093 cases were selected. The mean ages were 74.1 +/- 11.5 years for males and 80.6 +/- 10.7 for females in 1996, and 71.8 +/- 11.7 for males and 78.3 +/- 10.6 for females in 1997. Most of the cases were classified as appertaining to DRG 127--pure heart failure (56.7%). Heart failure associated with myocardial infarction accounted for 7.3% of cases. The remaining cases (36.0%) were classified as appertaining to heterogeneous medical and surgical DRGs. In 1997, the in-hospital mortality was 14.7% for patients aged > 80 years; 9.7% for patients aged between 71 and 80 years; 7.4% for patients aged between 61 and 70 years and 6.9% for patients < 61 years of age with the exclusion of pediatric cases. The in-hospital mortality was different between discharge units: 2.8% of in-patients discharged from cardiology units, and 10.3% of in-patients discharged from general medicine units. The readmission rate at 1 month was 5.49% whereas that within 1 year was 14.3%.


CONCLUSIONS
Heart failure mortality differences between hospital units are not explained by age and by comorbidity. The readmission rate was lower than in previous reports.
Gronda
Edoardo
E
Clinical Cardiology and Heart Failure Unit, Cardiovascular Department, Istituto Clinico Humanitas, Via Manzoni, 56 20089 Rozzano, MI. edoardo.gronda@humanitas.it
Mangiavacchi
Maurizio
M
Andreuzzi
Bruno
B
Municinò
Annamaria
A
Bologna
Alessandro
A
Schweiger
Carlo
C
Barbieri
Pietro
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003625:Data Collection; D003953:Diagnosis-Related Groups; D019317:Evidence-Based Medicine; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010359:Patient Readmission; D012307:Risk Factors