TY - JOUR
AU - Shoaib, Ahmad
AU - Van Spall, Harriette G.C.
AU - Wu, Jianhua
AU - Cleland, John G.F.
AU - McDonagh, Theresa A.
AU - Rashid, Muhammad
AU - Mohamed, Mohamed O.
AU - Ahmed, Fozia Z.
AU - Deanfield, John
AU - de Belder, Mark
AU - Gale, Chris
AU - Mamas, Mamas A.
PY - 2021
DA - May
TI - Comparison of in-patient and post discharge clinical outcomes for hospitalized heart failure patients in pre and COVID-19 period
JO - European Heart Journal: Quality of Care and Clinical Outcomes
EP - 387
VL - 7
IS - 4
DO - http://dx.doi.org/10.1093/ehjqcco/qcab040
AB - Objective: We hypothesised that a decline in admissions with heart failure during COVID-19 pandemic would lead to a reciprocal rise in mortality for patients with heart failure in the community.  Methods: We used national heart failure audit data to identify 36,974 adults who had a hospital admission with a primary diagnosis of heart failure between February and May in either 2018, 2019 or 2020.  Results: Hospital admissions for heart failure in 2018/19 averaged 160/day but were much lower in 2020, reaching a nadir of 64/day on 27th March-2020 (incidence rate ratio:0.40, 95% CI:0.38-0.42). The proportion discharged on guideline-recommended pharmacotherapies was similar in 2018/19 compared to the same period in 2020. Between 1st February-2020 and 31st May-2020, there was a 29% decrease in hospital deaths related to heart failure (IRR:0.71,95% CI:0.67-0.75; estimated decline of 448 deaths), a 31% increase in heart failure deaths at home (IRR:1.31,95% CI:1.24-1.39; estimated excess 539) and a 28% increase in heart failure deaths in care homes and hospices (IRR:1.28,95% CI:1.18-1.40; estimated excess 189). All-cause, in-patient death was similar in the COVID-19 and pre-COVID-19 periods (OR:1.02,95% CI: 0.94–1.10). After hospital discharge, 30-day mortality was higher in 2020 compared to 2018/19 (OR:1.57, 95% CI:1.38–1.78).  Conclusion: Compared with the rolling daily average in 2018/19, there was a substantial decline in admissions for heart failure but an increase in deaths from heart failure in the community. Despite similar rates of prescription of guideline-recommended therapy, mortality 30-days from discharge was higher during the COVID-19 pandemic period.
PB - Oxford University Press
UR - http://eprints.gla.ac.uk/242305/
KW - Coronavirus (COVID-19)
ER