In-hospital mortality in heart failure in Germany during the Covid-19 pandemic.
In-hospital mortality in heart failure in Germany during the Covid-19 pandemic.
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DOI：
10.1002/ehf2.13011
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发表时间：
2020-12
影响因子：
3.8
通讯作者：
Hindricks G
中科院分区：
文献类型：
--
作者：
Bollmann A;Hohenstein S;König S;Meier-Hellmann A;Kuhlen R;Hindricks G
Covid-19 大流行影响了心血管疾病的护理，但有关心力衰竭 (HF) 的数据很少。本研究旨在分析德国大流行期间的心力衰竭护理和住院结果。使用 65 家 Helios 医院的索赔数据对总共 9452 例心力衰竭住院患者进行了研究；研究期间（2020年3月13日至4月30日）为1979个，两个对照期（2019年3月13日至4月30日和2020年1月1日至3月12日）为4691和2782。与两个控制期相比，心力衰竭入院率下降了 29-38%。研究期间植入心脏再同步治疗的比例为 0.55%，前一年为 0.32% [比值比 (OR) 1.66，95% 置信区间 (CI) 0.68–4.04，P = 0.27]，2017 年为 0.43%（OR 1.35，95% CI 0.64–2.84，P = 0.43）。同年控制。研究期间重症监护治疗率为6.22%，前一年为4.49%（OR 1.46，95% CI 1.13-1.89，P < 0.01），同年对照为5.27%（OR 1.19，95% CI 0.96-1.49，P = 0.12）。研究中的住院时间为 7.0 ± 5.0 天，对照组为 7.8 ± 5.6 天（P < 0.01）和 7.3 ± 5.1 天（P = 0.07）。研究中的院内死亡率为 7.0%，两个对照期的院内死亡率均为 5.5%（P < 0.05）。在德国Covid-19大流行的早期阶段，心衰治疗途径似乎没有受到影响，但住院时间缩短，院内死亡率增加。随着大流行的持续，这一早期信号需要密切监测并进一步调查潜在原因。
The Covid‐19 pandemic affects care for cardiovascular conditions, but data on heart failure (HF) are scarce. This study aims to analyse HF care and in‐hospital outcomes during the pandemic in Germany. A total of 9452 HF admissions were studied using claims data of 65 Helios hospitals; 1979 in the study period (13 March 30 April 2020) and 4691 and 2782 in two control periods (13 March to 30 April 2019 and 1 January to 12 March 2020). HF admissions declined compared with both control periods by 29–38%. Cardiac resynchronization therapy was implanted in 0.55% during the study period, 0.32% [odds ratio (OR) 1.66, 95% confidence interval (CI) 0.68–4.04, P = 0.27] in the previous year and 0.43% (OR 1.35, 95% CI 0.64–2.84, P = 0.43) in the same year control. Intensive care treatment was 6.22% during the study period, 4.49% in the previous year (OR 1.46, 95% CI 1.13–1.89, P < 0.01), and 5.27% in the same year control (OR 1.19, 95% CI 0.96–1.49, P = 0.12). Length of hospital stay was 7.0 ± 5.0 days in the study and 7.8 ± 5.6 (P < 0.01) and 7.3 ± 5.1 days (P = 0.07) in the control periods. In‐hospital mortality was 7.0% in the study and 5.5% in both control periods (P < 0.05). During the early phase of the Covid‐19 pandemic in Germany, HF treatment pathways seem not to be affected, but hospital stay shortened and in‐hospital mortality increased. As the pandemic continues, this early signal demands close monitoring and further investigation of potential causes.
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