Trends in HF Hospitalizations Among Young Adults in the United States From 2004 to 2018,JACC: Heart Failure

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Trends in HF Hospitalizations Among Young Adults in the United States From 2004 to 2018
JACC: Heart Failure ( IF 10.3 ) Pub Date : 2022-04-25 , DOI: 10.1016/j.jchf.2022.01.021
Vardhman Jain ₁ , Abdul Mannan Khan Minhas ₂ , Safi U Khan ₃ , Stephen J Greene ₄ , Ambarish Pandey ₅ , Harriette G C Van Spall ₆ , Gregg C Fonarow ₇ , Robert J Mentz ₄ , Javed Butler ₈ , Muhammad Shahzeb Khan ₄

Affiliation

Objectives

The aim of this study was to assess trends in heart failure (HF) hospitalizations among young adults.

Background

Data are limited regarding clinical characteristics and outcomes of young adults hospitalized for HF.

Methods

The National Inpatient Sample database was analyzed to identify adults aged 18 to 45 years who were hospitalized for HF between 2004 and 2018.

Results

In total, 767,180 weighted hospitalizations for HF in young adults were identified, equivalent to 4.32 (95% CI: 4.31-4.33) per 10,000 person-years. Overall HF hospitalizations per 10,000 U.S. population of young adults decreased from 2.43 in 2004 to 1.82 in 2012, followed by an increase to 2.51 in 2018. Black adults (50.1%) had a significantly higher proportion of HF hospitalizations compared with White (31.9%) and Hispanic adults (12.2%) throughout the study period. Nearly half of patients (45.8%) lived in zip codes in the lowest quartile of national household income. Overall, in-hospital mortality was 1.3%, which decreased over time; this trend was consistent by sex and race. The overall mean LOS (5.2 days) remained stable over time, while the mean inflation-adjusted cost increased from $12,449 in 2004 to $16,786 in 2018, with significant overall differences by race and sex.

Conclusions

This longitudinal examination of U.S. clinical practice revealed that HF hospitalizations among young adults have increased since 2013. Approximately half of these patients are Black and reside in zip codes in the lowest quartile of national household income. Temporal trends showed decreased in-hospital mortality, stable adjusted lengths of stay, and increased inflation-adjusted costs, with significant racial differences in hospitalization rates.

中文翻译：

2004 年至 2018 年美国年轻人心衰住院的趋势

目标

本研究的目的是评估年轻人心力衰竭 (HF) 住院的趋势。

背景

关于因 HF 住院的年轻人的临床特征和结果的数据有限。

方法

对全国住院患者样本数据库进行了分析，以确定 2004 年至 2018 年期间因 HF 住院的 18 至 45 岁的成年人。

结果

总共确定了 767,180 例年轻人因 HF 加权住院，相当于每 10,000 人年 4.32 例（95% CI：4.31-4.33）。每 10,000 名美国年轻人的心衰住院总人数从 2004 年的 2.43 人下降到 2012 年的 1.82 人，随后在 2018 年增加到 2.51 人。与白人 (31.9%) 相比，黑人成人 (50.1%) 心衰住院的比例明显更高整个研究期间的西班牙裔成年人（12.2%）。近一半的患者（45.8%）居住在全国家庭收入最低四分之一的邮政编码中。总体而言，住院死亡率为 1.3%，随着时间的推移而下降；这种趋势在性别和种族方面是一致的。总体平均 LOS（5.2 天）随着时间的推移保持稳定，而经通胀调整后的平均成本从 2004 年的 12,449 美元增加到 2018 年的 16,786 美元，