AIMS: Heart failure (HF) hospitalization rates are decreasing in western Europe, but little is known about trends in central and east European countries. We analysed the Slovenian national hospitalization database to determine the burden of HF hospitalization. METHODS AND RESULTS: The Slovenian National Hospital Discharge Registry was searched for HF hospitalizations between 2004 and 2012 in patients aged ?20 years. A total of 55 531 main HF hospitalizations (43 636 first HF hospitalizations) in 34 406 patients (median age 78 years, 55% female) were recorded. The most common co-morbidities were arterial hypertension (54.3%), atrial fibrillation (40.6%), diabetes mellitus (24.5%), and ischaemic heart disease (21.9%). The number of age-standardized main and first HF hospitalizations per 100 000 population decreased from 249 to 232 (7.1%, P = 0.002) and from 467 to 435 (6.8%, P = 0.074), respectively. Crude main and first HF hospitalization rates increased from 249 to 298 (19.8%, P ( 0.001) and from 530 to 558 (5.4%, P = 0.100), respectively. After a first HF hospitalization, any HF readmission rates within 30, 60, and 90 days and at 1 year were 11.7, 17.2, 20.9, and 37.5%, respectively. Hospitalization trends were similar in both sexes and across all age groups. In a multivariate log binomial regression model, myocardial infarction, chronic kidney disease, diabetes mellitus, male sex, and year of admission were independently associated with higher HF readmission rates (P ( 0.01 for all).CONCLUSIONS: In Slovenia, standardized HF hospitalization rates have decreased but the crude HF hospitalization burden has increased. Readmissions were associated with established cardiovascular risk factors.
COBISS.SI-ID: 3702245
BACKGROUND: In heart failure (HF), comorbidity burden and prognostic risks increase with age. Studies investigating outcome in elderly patients from large datasets are lacking, particularly in central and eastern European countries. We analyzed the Slovenian data on mortality and readmissions after first HF hospitalization in patients aged 65 years or over. METHODS: In this observational epidemiological study, the Slovenian national hospitalization database was searched for HF patients aged ?65 years with first HF hospitalization between 2008 and 2012. All-cause mortality and readmissions were compared in young-olds (65-74 years), middle-olds (75-84 years), and old-olds (?85 years) using cumulative probability plots and log rank test. The prognostic value of comorbidities on mortality and readmissions for age groups were assessed using multiple Cox proportional hazards models. RESULTS: Overall, 36,824 patients were included (median age 80 years, 41?% men, 20?% in-hospital mortality). The proportions of young-olds, middle-olds, and old-olds were 26, 48, and 26?%, respectively. Arterial hypertension (60?%), pulmonary disease (44?%), and atrial fibrillation (38?%) were the most prevalent comorbidities, with little variation over age. While age group was associated with higher mortality (P ( 0.001), no such associations were seen for readmissions at any time points (P ) 0.1 for all). Importance of comorbidities as a predictor for mortality faded with increasing age while only small decrease in hazard ratios for readmissions were seen. CONCLUSIONS: Age is an independent predictor of mortality but not readmissions in elderly patients with first HF hospitalization. Comorbidities are important predictors for mortality and readmissions in elderly.
COBISS.SI-ID: 3759845
Heart failure (HF) is a rapidly growing public health problem and the leading cause of mor- bidity, mortality, and hospitalization in populations ) 65 years. The elderly HF patients have an increased prevalence of HF with preserved ejection fraction and comorbidities, may prese nt with atypical symptoms and signs, have a higher risk for adverse drug reac- tions, and worse prognosis as compared with younger patients. Moreover, there is a lack of evidence-based therapies for this population because they are un- derrepresented in the clinical trials. The elderly are less likely to be evaluate dbyacardiologistandto be treated in accordance with recommendations of the current HF guidelines. Although the treatment is improving, it is still suboptimal; therefore, HF in elderly patients requires mob ilization of public health services and improvement of treatment strategies.
COBISS.SI-ID: 3800293
Background: Self-care is an important element in the comprehensive management of patients with heart failure. The European Heart Failure Self-Care Behaviour Scale (EHFScBS) was developed and tested to measure behaviours performed by the heart failure patients to maintain life, healthy functioning, and wellbeing. Aims: The purpose of this review was to evaluate the importance of factors associated with heart failure self-care behaviours as measured by the EHFScBS. Methods: Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to search major health databases (PubMed, Scopus and ScienceDirect). Obtained associating factors of heart failure self-care were qualitatively synthesised and the association levels of most commonly addressed factors were further explored. Results: We identified 30 studies that were included in the review; a diverse range of personal and environmental factors associated with self-care behaviours in heart failure patients were identified. Age, health-related quality of life, gender, education, New York Heart Association class, depressive symptoms and left ventricular ejection fraction were most often correlated with the EHFScBS score. Consistent evidence for the relationship between self-care behaviours and depression was found, while their association with New York Heart Association class and health-related quality of life was non-significant in most of the studies. Associations with other factors were shown to be...
COBISS.SI-ID: 3858149
OBJECTIVE: The aim of this study was to review and evaluate the evidence related to psychometric properties of the European Heart Failure Self-Care Behaviour Scale (EHFScBS) that was developed and tested to measure health maintenance behaviours of heart failure (HF) patients and translated into several languages. METHODS: PRISMA guidelines were used to search major health databases (PubMed, Scopus and ScienceDirect), to identify relevant studies. A literature search was undertaken in November 2015. An integrative review, aiming to bring together all evidence relating to the psychometric properties (validity, reliability) of the EHFScBS was conducted. RESULTS: 13 eligible studies were included. The results showed content, discriminant and convergent validity of the 9- and 12-item scale across the samples, while the factor structure of both versions of the scale was inconsistent. Most commonly used reliability estimates (Cronbach's alpha) of the total scale were satisfactory. CONCLUSION: Overall, published data demonstrate satisfactory psychometric properties of the EHFScBS, indicating that the scale is a reliable and valid tool for measuring health maintenance behaviours of HF patients. PRACTICE IMPLICATIONS: Taking the findings regarding the factorial structure of the scale into account, we recommend the use of the total EHFScBS score or scores on specific items.
COBISS.SI-ID: 3858405