title: Trends and Characteristics of Hospitalization for Heart Failure in a Population Setting From 2003 to 2013.
abstract: OBJECTIVE
  Population-based studies in other countries have reported a reduction of standardized rates of hospitalization for heart failure (HF) but data from a well-defined population are lacking in Spain.
  
  
  METHODS
  All hospitalizations with a principal diagnosis of HF between 2003 and 2013 were obtained from the Minimum Basic Data Set, which includes all hospitals in the Region of Murcia. Health care episodes were identified by the individual health card (27 158 episodes). For each year, we studied the following parameters: crude, age-standardized and sex-standardized hospitalization rates for HF, length of stay, mortality, clinical variables, and the Elixhauser index. Time trends were analyzed using joinpoint regression.
  
  
  RESULTS
  Hospitalization rates increased by 76.7%, from 1.28‰ to 2.26‰ (crude) and 1.06‰ to 1.77‰ (standardized); the mean annual percentage of change (APC) was 8.2% until 2007 and was subsequently 1.9% (P < .05). Rates doubled in persons ≥ 75 years, reaching 19.9‰ in those aged 75 to 84 years (APC, 5.4%) and 32.5‰ in those aged ≥ 85 years (APC, 11.7%) but were unchanged in persons aged < 75 years. The hospitalization rate was 36% higher in women than in men but was equal after age-standardization and showed no temporal change. The Elixhauser comorbidity index increased by almost 1 point during the study period and episodes > 6 points increased by 2-fold. Length of stay and mortality were unchanged during the study period.
  
  
  CONCLUSIONS
  Between 2003 and 2013, there was a sustained increase in standardized rates of hospitalization for HF, which affected persons ≥ 75 years and was associated with a rise in comorbidity. There is a need for strategies focused on this population.
authors.affiliation: Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: María Lucía
authors.initials: ML
authors.lastname: Fernández Gassó
authors.affiliation: Servicio de Planificación y Financiación Sanitaria, Consejería de Sanidad, Murcia, Spain.
authors.forename: Lauro
authors.initials: L
authors.lastname: Hernando-Arizaleta
authors.affiliation: Servicio de Planificación y Financiación Sanitaria, Consejería de Sanidad, Murcia, Spain.
authors.forename: Joaquín A
authors.initials: JA
authors.lastname: Palomar-Rodríguez
authors.affiliation: Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Soria-Arcos
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, El Palmar, Murcia, Spain. Electronic address: dpascual@um.es.
authors.forename: Domingo A
authors.initials: DA
authors.lastname: Pascual-Figal
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009026:Mortality; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Epidemiology; Epidemiología; Heart failure; Hospitalización; Hospitalization; Insuficiencia cardiaca