Age-adjusted HF hospitalizations declining in US, but race, sex disparities exist

ORLANDO, Fla. — U.S. age-adjusted HF hospitalization rates have significantly decreased over the last decade, according to a poster presented at the Heart Failure Society of America Scientific Assembly.

However, black and Hispanic individuals had a higher rate of HF hospitalization than white and Asian people, and men had a higher rate than women, the researchers reported.

The analysis included single-year age adjustment, which allows for removal of residual bias related to differences in age distributions by sex and race/ethnicity, according to the researchers.

“These data demonstrate that progress has been made in reducing age-adjusted hospitalization rates for HF over the past decade in the United States,” researcher Gregg C. Fonarow, MD, professor of cardiovascular medicine at UCLA, told Cardiology Today. “Nevertheless, there are very important opportunities to further improve care and outcomes as well as prevent incident HF.”

Gregg C. Fonarow

Using the National Inpatient Sample (NIS), the researchers were able to estimate the number of HF hospitalizations per year of life by subgroup in the United States.

Hospitalization care utilization and cost data was collected via the Agency for Healthcare research and Quality’s Healthcare Cost and Utilization Project, and ICD-9 codes were used to identified primary HF-related discharge.

According to the study, between 2002 and 2013, the overall rate of U.S. HF hospitalization dropped 30.7%, from 526.86 per 100,000 people to 364.66 per 100,000 (P for trend = .001).

HF hospitalization rates decreased from 581.69 per 100,000 to 431.4 per 100,000 (25.8%; P for trend = .001) in men and from 486.2 per 100,000 to 301.99 per 100,000 (36%; P for trend = .001) in women, the researchers found.

Among races and ethnicities, the Asian subgroup had the lowest rate of HF hospitalization (2002, 342.47 per 100,000; 2013, 181.09 per 100,000; P for trend = .002) and the sharpest decline (47.2%), the researchers wrote.

The researchers found that although age-adjusted HF hospitalization rates among black individuals decreased from 1,048.31 per 100,000 to 740.99 per 100,000, a decline of 29.3% (P for trend = .005), black people were still more than twice as likely to be hospitalized for HF compared with white people (2002, 448.29 per 100,000; 2013, 315.47 per 100,000; decrease, 29.65%; P for trend = .001).

Compared with the white subgroup, the Hispanic subgroup also had higher rates of age-adjusted HF hospitalization (2002, 649.53 per 100,000; 2013, 337.47 per 100,000; decline, 48%, P for trend = .001), according to the researchers.

“There remain important disparities in HF hospitalization rates by sex, race and ethnicity, pointing to the need for equitable improvement in HF care,” Fonarow told Cardiology Today.

The researchers wrote that while the data show a decline in national age-adjusted hospitalization for HF, the NIS does not distinguish between index hospitalization and readmission of patients, so a small margin of HF admissions may represent readmissions of the same patient. – by Dave Quaile

Reference:

Ziaeian B, Fonarow GC. Poster 066. Presented at: Heart Failure Society of America Scientific Assembly; Sept. 17-20, 2016; Orlando, Fla.

Disclosure: Fonarow reports receiving consultant fees from Amgen and Novartis.