Epidemiology of heart failure in Germany: a retrospective database study
Epidemiology of heart failure in Germany: a retrospective database study
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DOI：
10.1007/s00392-017-1137-7
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发表时间：
2017-11-01
影响因子：
5
通讯作者：
Klebs, Sven
中科院分区：
文献类型：
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作者：
Stoerk, Stefan;Handrock, Renate;Klebs, Sven
背景 慢性心力衰竭（HF）与大量的医疗支出、发病率和死亡率相关。这项研究调查了德国心力衰竭的流行病学。方法这项回顾性研究使用了德国健康风险研究所针对拥有法定健康保险的个人的匿名医疗索赔数据。包括2009年1月1日至2013年12月31日不间断数据或死亡（以先发生者为准）的患者，以及2011年≥2次记录的心衰相关诊断的患者。确定了新诊断的心力衰竭患者。自首次诊断后对患者进行了为期 2 年的随访。结果 在 3,132,337 名符合条件的患者中，123,925 名（55.0% 为女性；平均年龄 76.2 岁）患有心力衰竭：患病率为 3.96%。其中，26,368 人新诊断出心力衰竭：发病率为 655/100,000 的高危人群。发病率随着年龄的增长而增加，并且无论性别如何，发病率都相似。随访期间，新诊断患者入院48,159例（1.8例住院/患者/2年）； HF占其中的6%。此外，共有 20,148 名患者（16.3%）死亡，其中新诊断患者 5983 名（22.7%）死亡。大多数心力衰竭新病例是由办公室医生诊断的（63.2%）；住院患者中的新增病例主要由内科专家诊断（70.7%）。总体而言，94.0% 的人从家庭医生处获得了心力衰竭治疗的初始处方。 结论 在该代表性样本中观察到的高患病率和发病率强调了德国心力衰竭的负担。大量的住院率和死亡率凸显了早期诊断和适当治疗的必要性，以及医生专业和医疗保健部门之间密切合作的必要性。
Background Chronic heart failure (HF) is associated with significant healthcare expenditure, morbidity, and mortality. This study investigated the epidemiology of HF in Germany.Methods This retrospective study used anonymous healthcare claims data from the German Health Risk Institute on individuals with statutory health insurance. Patients with uninterrupted data from 1 January 2009 to 31 December 2013 or death (whichever occurred first), and >= 2 recorded HF-related diagnoses in 2011, were included. Patients with newly diagnosed HF were identified. Patients were followed up for 2 years from first diagnosis.Results Of 3,132,337 eligible patients, 123,925 (55.0% women; mean age 76.2 years) had HF: a prevalence of 3.96%. Of these, 26,368 had newly diagnosed HF: an incidence of 655/100,000 persons at risk. Incidence increased with age and was similar regardless of sex. During follow-up, there were 48,159 hospital admissions among newly diagnosed patients (1.8 hospitalizations/patient/2 years); HF accounted for 6% of these. Additionally, 20,148 patients (16.3%) overall and 5983 newly diagnosed patients (22.7%) died. Most new cases of HF were diagnosed by office-based physicians (63.2%); new cases among hospital inpatients were predominantly diagnosed by internal medicine specialists (70.7%). Overall, 94.0% received their initial prescription for HF treatment from a family practitioner.Conclusions The high prevalence and incidence observed in this representative sample emphasize the burden of HF in Germany. Substantial hospitalization rates and mortality highlight the need for early diagnosis and appropriate treatment, and for close cooperation between physician specialties and healthcare sectors.