title: Two-year outcome of patients after a first hospitalization for heart failure: A national observational study.
abstract: BACKGROUND
  National population-based management and outcome data for patients of all ages hospitalized for heart failure have rarely been reported.
  
  
  OBJECTIVE
  National population-based management and outcome of patients of all ages hospitalized for heart failure have rarely been reported. The present study reports these results, based on 77% of the French population, for patients hospitalized for the first time for heart failure in 2009.
  
  
  METHODS
  The study population comprised French national health insurance general scheme beneficiaries hospitalized in 2009 with a principal diagnosis of heart failure, after exclusion of those hospitalized for heart failure between 2006 and 2008 or with a chronic disease status for heart failure. 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 studied. The hospital mortality rate was 6.4%, with 1-month, 1-year and 2-year survival rates of 89%, 71% and 60%, respectively. Heart failure and all-cause readmission-free rates were 55% and 43% at 1 year and 27% and 17% at 2 years, respectively. Compared with a reference sample of 600,000 subjects, the age- and sex-standardized relative risk of death was 29 (95% confidence interval [CI] 28-29) at 2 years, 82 (95% CI 72-94) in subjects aged<50 years and 3 (95% CI 3-3) in subjects aged ≥ 90 years. For subjects aged < 70 years who survived 1 month after discharge, factors associated with a reduction in the 2-year mortality rate were: female sex; age < 55 years; absence of co-morbidities; and use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, lipid-lowering agents or oral anticoagulants during the month following discharge. Poor prognostic factors were treatment with a loop diuretic before or after hospitalization and readmission for heart failure within 1 month after discharge.
  
  
  CONCLUSIONS
  This large population-based study confirms the severe prognosis of heart failure and the need to promote the use of effective medications and management designed to improve survival.
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.affiliation: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Cuerq
authors.affiliation: Institut de Veille Sanitaire, Saint-Maurice, France.
authors.forename: Christine
authors.initials: C
authors.lastname: de Peretti
authors.affiliation: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Fagot-Campagna
authors.affiliation: Hôpital Européen Georges-Pompidou, Université Paris Descartes, Département de Cardiologie, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.affiliation: Cardiologie, Institut Lorrain du Cœur et des Vaisseaux Louis-Mathieu, Nancy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.affiliation: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.affiliation: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS), Paris, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Allemand
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Milou-Daniel
authors.initials: MD
authors.lastname: Drici
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Hagège
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jourdain
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Leizorovicz
authors.affiliation: Heart Failure group from the CNAMTS, scientific council, Paris, France.
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002423:Cause of Death; D015897:Comorbidity; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D012017:Referral and Consultation; D012307:Risk Factors; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000960:Hypolipidemic Agents; D049994:Sodium Potassium Chloride Symporter Inhibitors
keywords: France; Heart failure; Hospitalisation; Hospitalization; Incidence; Insuffisance cardiaque; SNIIRAM