Annual rates of admission and seasonal variations in hospitalizations for heart failure

Abstract

Aims: To investigate the annual hospitalization rate and seasonal variation in confirmed heart failure (HF) admissions. Methods and Results: Records from all admissions to one hospital during 1 year with a HF diagnostic code were reviewed. From 1953 admissions, 595 were excluded because they did not fulfill the diagnostic criteria. A total of 1069 patients had 1358 admissions with confirmed HF. Mean age was 74.8"11.5 years, 42% were males. The admission data were matched with data from the municipal census with 537 666 people aged G15 years. There were 2.5 admissions per 1000 for the adult population and 26.5y 1000 in those aged G80 years. There were 444 males and 625 females, giving a higher rate of admission for female patients 2.2y1000 vs. 1.7y1000 (P-0.0001), although age adjusted rates in females were higher only for G80 years. Echocardiogram was performed in 706 patients (66%), 325 (46%) had a normal ejection fraction. This proportion increased in females-64% vs. 29% males-and in older patients-55% in G75 vs. 39% in -75 years. Mortality during the first admission of 1996 was 8.3%. There was a seasonal variation in HF hospitalizations (P-0.0001) peaking at 25% above average in January and dipping to 33% below average in August. Conclusion: The rate of HF admissions was 2.5y1000 with an elderly preponderance and a higher rate of admission in males -80 years and in females G80 years. A seasonal variation ranging from 25% above average in January to 33% below average in August was observed.

A Community Based Epidemiological and Clinical Study of Hospitalization of Patients With Congestive Heart Failure in Northern Iwate, Japan

“…A similar seasonal variation has been reported from European countries. [31][32][33] Although the precise reasons for this variation remain unknown, a potential explanation might be the presence of some other condition with a well-known seasonal variation such as respiratory tract infection, myocardial infarction and ischemia, or high blood pressure. Heart rate and systemic blood pressure have been reported to rise in cold environments, thus increasing cardiac oxygen consumption and cardiac afterload.…”

Clinical Scenario 1 Is Associated With Winter Onset of Acute Heart Failure

“…Martínez-Sellés et al found a higher rate of hospitalization of males aged <80 years and females aged ≥80 years. 10 Kaneko et al 27 reported that patients with preserved EF, older age, hypertension, and CS1 were susceptible to winter admission of AHF. They emphasized the importance of BP control during…”

The seasonality in heart failure deaths and total cardiovascular deaths

“…1 Similar strong seasonal peaks in admissions to hospital have also been observed in relation to heart failure. [2][3][4][5] Counter-intuitively, the seasonal pattern is strongest in regions with warmer climates. 6,7 For example, a strong association between relatively cold temperatures and cardiovascular disease was found in Newcastle, Australia, but no association was found in three populations in Finland.…”

“…6,7 For example, a strong association between relatively cold temperatures and cardiovascular disease was found in Newcastle, Australia, but no association was found in three populations in Finland. 1 Winter increases in heart failure (HF) admissions have been found in France, 2 Spain, 3 Scotland, 4 Japan, 5 and Argentina. 8 In France, HF deaths were 20% above average in January and 15% below average in August.…”