Temporal evolution of the profile of patients hospitalized with heart failure (2000–2022)

Abstract

[Abstract] Background: The clinical characteristics of patients who have a first episode of congestive heart failure (CHF) may have changed in recent years.

Methods: A retrospective cohort study was performed on 19,796 patients discharged from medical departments with a diagnosis of CHF between 1 January 2000 and 31 December 2022. Data were drawn from two data sets of the Minimum Basic Data Set-Hospital Data Set (MBDS) of the Lucus Augusti University Hospital (Spain): hospitalizations and patients. Patient characteristics (including the period of their first admission) and the association rules between diseases determined using the Apriori algorithm were studied in five consecutive time periods.

Results: The general characteristics of patients on first admission for CHF changed over time. There were increases in mean age (75.9 ± SD 11.2 vs. 81.6 ± SD 11.5 years; p < 0.0001), the proportion of women (48.3% vs. 51.4; p = 0.0001), the number of acute diseases (1.1 ± SD 1.4 to 2.7 ± SD 2.5; p < 0.0001), and the number of chronic diseases (3.6 ± SD 1.9 to 6.5 ± SD 2.6); p < 0.001). Accordingly, the median number of diagnoses (from 3 to 7) and itemsets per patient increased (mean number of items 1.75 vs. 3.4; p < 0.0001), and the associations of diseases leading to CHF became more complex.

Conclusions: This single-center study shows that in the last two decades, the characteristics of patients with a first hospital admission for CHF have changed. Patients are older, there is a predominance of women, and they have a greater number of acute and chronic concomitant diseases, making their clinical management more difficult.