title: Trends in heart failure hospitalizations, patient characteristics, in-hospital and 1-year mortality: A population study, from 2000 to 2012 in Lombardy.
abstract: BACKGROUND
  This study was undertaken to evaluate trends in heat failure hospitalizations (HFHs) and 1-year mortality of HFH in Lombardy, the largest Italian region, from 2000 to 2012.
  
  
  METHODS
  Hospital discharge forms with HF-related ICD-9 CM codes collected from 2000 to 2012 by the regional healthcare service (n=699797 in 370538 adult patients), were analyzed with respect to in-hospital and 1-year mortality; Group (G) 1 included most acute HF episodes with primary cardiac diagnosis (70%); G2 included cardiomyopathies without acute HF codes (17%); and G3 included non-cardiac conditions with HF as secondary diagnosis (13%). Patients experiencing their first HFH since 2005 were analyzed as incident cases (n=216782).
  
  
  RESULTS
  Annual HFHs number (mean 53830) and in-hospital mortality (9.4%) did not change over the years, the latter being associated with increasing age (p<0.0001) and diagnosis Group (G1 9.1%, G2 5.6%, G3 15.9%, p<0.0001). Incidence of new cases decreased over the years (3.62 [CI 3.58-3.67] in 2005 to 3.13 [CI 3.09-3.17] in 2012, per 1000 adult inhabitants/year, p<0.0001), with an increasing proportion of patients aged ≥85y (22.3% to 31.4%, p<0.0001). Mortality lowered over time in <75y incident cases, both in-hospital (5.15% to 4.36%, p<0.0001) and at 1-year (14.8% to 12.9%, p=0.0006).
  
  
  CONCLUSIONS
  The overall burden and mortality of HFH appear stable for more than a decade. However, from 2005 to 2012, there was a reduction of new, incident cases, with increasing age at first hospitalization. Meanwhile, both in-hospital and 1-year mortality decreased in patients aged <75y, possibly due to improved prevention and treatment.
authors.affiliation: De Gasperis Cardiocenter, Niguarda-Ca'Granda Hospital, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Frigerio
authors.affiliation: Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mazzali
authors.affiliation: MOX - Department of Mathematics, Politecnico di Milano, Milan, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paganoni
authors.affiliation: MOX - Department of Mathematics, Politecnico di Milano, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ieva
authors.affiliation: ASST Melegnano e della Martesana, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Barbieri
authors.affiliation: ASST Melegnano e della Martesana, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Maistrello
authors.affiliation: Cardiovascular Department, Santi Paolo e Carlo, Presidio San Carlo, Milan, Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Agostoni
authors.affiliation: Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Masella
authors.affiliation: Rehabilitation Cardiology Department and Continuity Care Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Lumezzane, Brescia, Italy. Electronic address: simonetta.scalvini@icsmaugeri.it.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Scalvini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011159:Population Surveillance / Q000379:methods; D055815:Young Adult
keywords: Epidemiology; Heart failure; Hospitalization; Mortality