Incidence and Clinical Significance of 30-Day and 90-Day Rehospitalization for Heart Failure Among Patients With Acute Decompensated Heart Failure in Japan　― From the NARA-HF Study ―

Abstract

Because the medical care system in Japan, which is a universal insurance system, is unique and quite different from that in the USA and Europe, the mean length of hospital stay in Japan is around 17 days, 16 which is much longer than in other countries.This study aimed to assess the incidence, timing, and clinical significance of HF rehospitalization after discharge in Japan to provide suggestions for improving medical care and prevent early HF rehospitalization. Methods Study PopulationThe NARA-HF 3 study, which has been described previously, 17,18 recruited 1,074 consecutive patients with acute decompensated HF (ADHF) who were emergently admitted to hospital between January 2007 and December 2016.

Association between class of foundational medication for heart failure and prognosis in heart failure with reduced/mildly reduced ejection fraction

“…All study participants were admitted to each participating hospital. The detailed study design of each registry has been reported previously 15 – 17 . All three registries included patients hospitalized with acute HF, regardless of the left ventricular ejection fraction (LVEF).…”

“…Patients with acute coronary syndrome were excluded from all three registries. The study protocols of all three registries were approved by the institutional review boards of each site, and all studies were conducted in compliance with the tenets of the Declaration of Helsinki 15 , 17 , 18 . The present study that aimed to analyze the dataset combining the three registries was approved by the Nara Medical University Institutional Ethics Committee (No.…”

Precipitating factors and clinical impact of early rehospitalization for heart failure in patients with heart failure in Awaji Island, Japan

“…In fact, 20% to 40% of the Japanese patients who were hospitalized for HF were readmitted within one year due to worsening HF [7][8][9] , and rehospitalization of HF cases soon after discharge frequently led to death [ 21 , 22 ]. Ishihara et al revealed that patients with a 90-day re-HHF had worse prognoses in terms of all-cause death than those without a 90-day re-HHF [10] . In fact, in the present study, the incidence of rehospitalization within 3 months after discharge was high (15.6%) in overall population of HF due to the greater inclusion of an aging population as compared to the other registries, and death was frequent among patients who were re-admitted within 3 months after discharge.…”

“…Despite its unfavorable prognosis, patients in Japan have improved because of the administration of evidencebased medications [6] ; however, there still exists a high rate of post-discharge rehospitalization in these patients [ 7 , 8 ], which is predictive of fatal outcomes [9] . Ishihara et al reported that patients with a 90-day rehospitalization for HF (re-HHF) had worse prognoses than those without a 90-day re-HHF in terms of allcause death and cardiovascular (CV) death [10] . Although Tsuchihashi et al have reported that the most commonly identified cause for rehospitalization was self-care behavior, such as poor compliance with medical and dietary treatment [7] , the precipitating factors contributing to early rehospitalization have not been evaluated.…”

Astragaloside IV alleviates heart failure by regulating SUMO‑specific protease 1

“…According to European data, acute HF accounts for 17.4% of all-cause mortality per year, while CHF accounts for 7.2% ( 2 ). In high-income countries, the cost of HF treatment accounts for 2-3% of the total health system expenditure, and is expected to more than double in the next 20 years ( 3 ). At present, the clinical treatment of HF drugs mainly includes diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers and glucocorticoid receptor antagonists ( 4 ).…”