Comorbidities and mortality associated with hospitalized heart failure in Canada

Abstract

Background: Heart failure (HF) is a leading morbid cause of hospitalization and death. HF is often accompanied by comorbid conditions, increasing the health care burden. This study describes hospital mortality and identifies comorbid conditions associated with HF.

Methods: Acute care hospital separations in 2005-2006, with a diagnosis of HF I50, I500, I501, I509 (The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA]) were identified from all Canadian jurisdictions except Québec.

Results: A total of 2,457,527 hospital separations among 1,812,923 individuals, identifying 8,212,869 diagnoses were reported. Among those, a total of 33,693 (1.9%) of all hospitalized individuals had a most responsible diagnosis of HF, accounting for 42,399 hospital separations. Further, HF was coded 77,049 times as a comorbid diagnosis, altogether occurring in 4.9% of all hospitalizations. The most common primary diagnoses associated with comorbid HF were acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), and pneumonia. Seniors had a much higher hospitalization rate due to HF. Hospitalized individuals with a primary diagnosis of HF had an almost 3-fold higher 30-day in-hospital mortality rate and nearly double the mean hospital stay than that for all causes. On average, hospitalizations with a primary diagnosis of HF had 3.9 comorbidities, most commonly chronic ischemic heart disease (IHD), atrial fibrillation and flutter, diabetes, renal failure, etc.; 1.7 times greater for HF than for all causes.

Conclusions: HF has a high in-hospital mortality rate particularly among the elderly and is associated with many cardiac and noncardiac conditions. HF necessitates long hospital stays, which increases the burden on the health care system in Canada.