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Inicio Medicina Clínica (English Edition) Hospital admissions and outcomes for systolic and diastolic heart failure in Spa...
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Vol. 162. Issue 5.
Pages 213-219 (March 2024)
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Vol. 162. Issue 5.
Pages 213-219 (March 2024)
Original article
Hospital admissions and outcomes for systolic and diastolic heart failure in Spain between 2016 and 2019: A population-based study
Hospitalizaciones y eventos por insuficiencia cardiaca sistólica y diastólica en España entre 2016 y 2019. Un estudio de base poblacional
Juan Luis Bonilla-Palomasa,
Corresponding author
jnlsbnll@hotmail.com

Corresponding author.
, Manuel Anguita-Sánchezb, Cristina Fernández-Pérezc,d, José Luis Bernal-Sobrinoc,e, María Garcíac, Náyade Pradoc, Nicolás Rosilloc, Julián Pérez-Villacastínf, Juan José Gómez-Doblasg, Francisco Javier Elola-Somozac
a Servicio de Cardiología, Hospital San Juan de la Cruz, Úbeda (Jaén), Spain
b Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
c Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain
d Departamento de Medicina Preventiva, Área Sanitaria de Santiago de Compostela y Barbanza, Instituto de Investigación de Santiago, Santiago de Compostela, La Coruña, Spain
e Departamento de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
f Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
g Servicio de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain
Article information
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Figures (1)
Tables (2)
Table 1. Profile of patients with systolic and diastolic heart failure.
Table 2. Multivariate analysis for in-hospital mortality of heart failure patients.
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Additional material (1)
Abstract
Background and purpose

In Spain there is a lack of population data that specifically compare hospitalization for systolic and diastolic heart failure (HF). We assessed clinical characteristics, in-hospital mortality and 30-day cardiovascular readmission rates differentiating by HF type.

Methods

We conducted a retrospective observational study of patients discharged with the principal diagnosis of HF from The National Health System’ acute hospital during 2016–2019, distinguishing between systolic and diastolic HF. The source of the data was the Minimum Basic Data Set. The risk-standardized in-hospital mortality ratio and risk-standardized 30-day cardiovascular readmission ratio were calculated using multilevel risk adjustment models.

Results

190,200 episodes of HF were selected. Of these, 163,727 (86.1%) were classified as diastolic HF and were characterized by older age, higher proportion of women, diabetes mellitus, dementia and renal failure than those with systolic HF. In the multilevel risk adjustment models, diastolic HF was a protective factor for both in-hospital mortality (Odds ratio-OR-: 0.79; 95% confidence interval [CI], 0.75−0.83; p < 0.001) and 30-day cardiovascular readmission versus systolic HF (OR: 0.93; 95%CI: 0.88−0.97; p = 0.002).

Conclusions

In Spain, between 2016 and 2019, hospitalization episodes for HF were mostly due to diastolic HF. According to the multilevel risk adjustment models, diastolic HF compared to systolic HF was a protective factor for both in-hospital mortality and 30-day cardiovascular readmission.

Keywords:
Heart failure
Admission
Systolic
Diastolic
In-hospital mortality
Readmission
Resumen
Antecedentes y objetivos

En España carecemos de datos poblacionales de hospitalizaciones por insuficiencia cardiaca (IC) según sea sistólica o diastólica. Analizamos las diferencias clínicas, en mortalidad intrahospitalaria y reingresos de causa cardiovascular a los 30 días entre ambos tipos.

Métodos

Estudio observacional retrospectivo de pacientes dados de alta con el diagnóstico principal de IC de los hospitales del Sistema Nacional de Salud entre 2016 y 2019, distinguiendo entre IC sistólica y diastólica. La fuente de datos fue el Conjunto Mínimo Básico de Datos del Ministerio de Sanidad. Se calcularon las razones de mortalidad intrahospitalaria y de reingreso a los 30 días estandarizadas por riesgo usando sendos modelos de regresión logística multinivel de ajuste de riesgo.

Resultados

Se seleccionaron 190.200 episodios de IC. De ellos, 163.727 (86,1%) fueron por IC diastólica y se caracterizaron por presentar mayor edad, mayor proporción de mujeres, de diabetes y de insuficiencia renal que los de IC sistólica. Según los modelos de ajuste de riesgo la IC diastólica, frente a la sistólica, se comportó como un factor protector de mortalidad intrahospitalaria (Odds ratio [OR]: 0,79; intervalo de confianza [IC]95% 0,75−0,83; p<0,001) y de reingreso de causa cardiovascular a los 30 días (OR: 0,93; IC95%: 0,88−0,97; p = 0,002).

Conclusiones

En España, entre 2016 y 2019, los episodios de hospitalización por IC fueron mayoritariamente por IC diastólica. Según los modelos de ajuste de riesgo la IC diastólica, con respecto a la sistólica, fue un factor protector de mortalidad intrahospitalaria y de reingreso de causa cardiovascular a los 30 días.

Palabras clave:
Insuficiencia cardiaca
Hospitalización
Sistólica
Diastólica
Mortalidad intrahospitalaria
Reingreso

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