title: First hospitalization for heart failure in France in 2009: patient characteristics and 30-day follow-up.
abstract: BACKGROUND
  The incidence of heart failure (HF) is stable in industrialized countries, but its prevalence continues to increase, especially due to the ageing of the population, and mortality remains high.
  
  
  OBJECTIVE
  To estimate the incidence in France and describe the management and short-term outcome of patients hospitalized for HF for the first time.
  
  
  METHODS
  The study population comprised French national health insurance general scheme beneficiaries (77% of the French population) hospitalized in 2009 with a principal diagnosis of HF after exclusion of those hospitalized for HF between 2006 and 2008 or with a chronic disease status for HF. Data were collected from the national health insurance information system (SNIIRAM).
  
  
  RESULTS
  A total of 69,958 patients (mean age 78 years; 48% men) were included. The incidence of first hospitalization for HF was 0.14% (≥ 55 years, 0.5%; ≥ 90 years, 3.1%). Compared with controls without HF, patients more frequently presented cardiovascular or other co-morbidities. The hospital mortality rate was 6.4% and the mortality rate during the 30 days after discharge was 4.4% (3.4% without readmission). Among 30-day survivors, all-cause and HF 30-day readmission rates were 18% (< 70 years, 22%; ≥ 90 years, 13%) and 5%, respectively. Reimbursements among 30-day survivors comprised at least a beta-blocker in 54% of cases, diuretics in 85%, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in 67%, a diuretic and ACEI/ARB combination in 23% and a beta-blocker, ACEI/ARB and diuretic combination in 37%.
  
  
  CONCLUSIONS
  Patients admitted for HF presented high rates of co-morbidity, readmission and death at 30 days, and there remains room for improvement in their drug treatments; these findings indicate the need for improvement in return-home and therapeutic education programmes.
authors.affiliation: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France. Electronic address: philippe.tuppin@cnamts.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Tuppin
authors.forename: Anne
authors.initials: A
authors.lastname: Cuerq
authors.forename: Christine
authors.initials: C
authors.lastname: de Peretti
authors.forename: Anne
authors.initials: A
authors.lastname: Fagot-Campagna
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.forename: Hubert
authors.initials: H
authors.lastname: Allemand
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
authors.forename: Milou-Daniel
authors.initials: MD
authors.lastname: Drici
authors.forename: Albert
authors.initials: A
authors.lastname: Hagège
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
authors.forename: Patrick
authors.initials: P
authors.lastname: Jourdain
authors.forename: Alain
authors.initials: A
authors.lastname: Leizorovicz
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: ACEI; AD; ALD; ARB; BNP; France; HF; Heart failure; Hospitalisation; Hospitalization; ICD 10; Incidence; Insuffisance cardiaque; International Classification of Diseases; PD; RR; SLM; SNIIRAM; Système National d’Information Inter-Régimes de l’Assurance Maladie; affections de longue durée; angiotensin II receptor blocker; angiotensin-converting enzyme inhibitor; associated diagnosis; brain natriuretic peptide; heart failure; local mutualist sections; principal diagnosis; relative risk