Background:Heart failure (HF)—a serious and costly condition—is increasingly prevalent. We estimated the US burden including emergency department (ED) visits, inpatient hospitalizations and associated costs, and mortality.Methods and Results:We analyzed 2006 to 2014 data from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample, the Healthcare Cost and Utilization Project National (nationwide) Inpatient Sample, and the National Vital Statistics System. International Classification of Disease codes identified HF and comorbidities. Burden was estimated separately for ED visits, hospitalizations, and mortality. In addition, criteria were applied to identify total unique acute events. Rates of primary HF (primary diagnosis or underlying cause of death) and comorbid HF (comorbid diagnosis or contributing cause of death) were calculated, age standardized to the 2010 US population. In 2014, there were an estimated 1 068 412 ED visits, 978 135 hospitalizations, and 83 705 deaths with primary HF. There were 4 071 546 ED visits, 3 370 856 hospitalizations, and 230 963 deaths with comorbid HF. Between 2006 and 2014, the total unique acute event rate for primary HF declined from 536 to 449 per 100 000 (relative percent change of –16%; P for trend, <0.001) but increased for comorbid HF from 1467 to 1689 per 100 000 (relative percentage change, 15%; P for trend, <0.001). HF-related mortality decreased significantly from 2006 to 2009 but did not change meaningfully after 2009. For hospitalizations with primary HF, the estimated mean cost was $11 552 in 2014, totaling an estimated $11 billion.Conclusions:Given substantial healthcare and mortality burden of HF, rising healthcare costs, and the aging US population, continued improvements in HF prevention, management, and surveillance are important.

中文翻译：

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2006 年至 2014 年美国心力衰竭事件的全国负担


背景：心力衰竭（HF）是一种严重且昂贵的疾病，越来越普遍。我们估计了美国的负担，包括急诊科 (ED) 就诊次数、住院治疗和相关费用以及死亡率。方法和结果：我们分析了医疗保健成本和利用项目全国急诊科样本、医疗保健成本和利用项目 2006 年至 2014 年的数据国家（全国）住院患者样本和国家生命统计系统。国际疾病分类代码确定了心力衰竭和合并症。分别估算急诊就诊、住院和死亡率的负担。此外，还应用标准来确定独特的急性事件总数。计算了原发性心力衰竭（主要诊断或潜在死亡原因）和合并心力衰竭（合并症诊断或促成死亡原因）的发生率，年龄标准化为 2010 年美国人口。 2014 年，估计有 1 068 412 人因原发性心力衰竭就诊、住院 978 135 人、死亡 83 705 人。共有 4 071 546 人次就诊急诊，3 370 856 人次住院治疗，230 963 人因合并心力衰竭死亡。 2006 年至 2014 年间，原发性心力衰竭的总独特急性事件发生率从每 10 万人 536 例下降到每 10 万人 449 例（相对百分比变化 –16%；趋势P ，<0.001），但共病心力衰竭从每 10 万人 1467 例增加到 1689 例。 100 000（相对百分比变化，15%； P表示趋势，<0.001）。从 2006 年到 2009 年，心力衰竭相关死亡率显着下降，但 2009 年之后没有显着变化。对于原发性心力衰竭住院治疗，2014 年估计平均费用为 11 552 美元，总计估计为 110 亿美元。结论：考虑到心力衰竭的巨大医疗保健和死亡率负担、不断上升的医疗保健成本以及美国人口老龄化，持续改进心力衰竭的预防、管理和监测非常重要。