TY - JOUR
T1 - Trends for Readmission and Mortality After Heart Failure Hospitalisation in Malaysia, 2007 to 2016
AU - Lim, Yvonne Mei Fong
AU - Ong, Su Miin
AU - Koudstaal, Stefan
AU - Hwong, Wen Yea
AU - Liew, Houng Bang
AU - Rajadurai, Jeyamalar
AU - Grobbee, Diederick E.
AU - Asselbergs, Folkert W.
AU - Sivasampu, Sheamini
AU - Vaartjes, Ilonca
N1 - Funding Information: The study was funded by a research grant from the Ministry of Health Malaysia (NMRR-19-1108-47994). YMFL is supported by the University Medical Center Utrecht Global Health Support Program and the BigData@Heart project (under Innovative Medicines Initiative 2 Joint Undertaking grant agreement number 116074) and FWA is supported by the UCL Hospital NIHR Biomedical Research Centre. Funding Information: We thank the Director-General of Health for his support in the publication of these findings. We are grateful to the Health Informatics Centre, National Registration Department and Department of Statistics Malaysia for providing the data used in this study. The study was funded by a research grant from the Ministry of Health Malaysia (NMRR-19-1108-47994). YMFL is supported by the University Medical Center Utrecht Global Health Support Program and the BigData@Heart project (under Innovative Medicines Initiative 2 Joint Undertaking grant agreement number 116074) and FWA is supported by the UCL Hospital NIHR Biomedical Research Centre. Publisher Copyright: © 2022 The Author(s).
PY - 2022
Y1 - 2022
N2 - Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisation in Asia is sparse. This study aimed to estimate readmission and mortality after hospitalisation among HF patients and examine temporal variation by sex and ethnicity. Methods: Data for 105,399 patients who had incident HF hospitalisations from 2007 to 2016 were identified from a national discharge database and linked to death registration records. The outcomes assessed here were 30-day readmission, in-hospital, 30-day and one-year all-cause mortality. Results: Eighteen percent of patients (n = 16786) were readmitted within 30 days. Mortality rates were 5.3% (95% confidence interval (CI) 5.1-5.4%), 11.2% (11.0-11.4%) and 33.1% (32.9-33.4%) for in-hospital, 30-day and 1-year mortality after the index admission. Age, sex and ethnicity-adjusted 30-day readmissions increased by 2% per calendar year while in-hospital and 30-day mortality declined by 7% and 4% per year respectively. One-year mortality rates remained constant during the study period. Men were at higher risk of 30-day readmission (adjusted rate ratio (RR) 1.16, 1.13-1.20) and one-year mortality (RR 1.17, 1.15-1.19) than women. Ethnic differences in outcomes were evident. Readmission rates were equally high in Chinese and Indians relative to Malays whereas Others, which mainly comprised Indigenous groups, fared worst for in-hospital and 30-day mortality with RR 1.84 (1.64-2.07) and 1.3 (1.21-1.41) relative to Malays. Conclusions: Short-term survival was improving across sex and ethnic groups but prognosis at one year after incident HF hospitalisation remained poor. The steady increase in 30-day readmission rates deserves further investigation.
AB - Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisation in Asia is sparse. This study aimed to estimate readmission and mortality after hospitalisation among HF patients and examine temporal variation by sex and ethnicity. Methods: Data for 105,399 patients who had incident HF hospitalisations from 2007 to 2016 were identified from a national discharge database and linked to death registration records. The outcomes assessed here were 30-day readmission, in-hospital, 30-day and one-year all-cause mortality. Results: Eighteen percent of patients (n = 16786) were readmitted within 30 days. Mortality rates were 5.3% (95% confidence interval (CI) 5.1-5.4%), 11.2% (11.0-11.4%) and 33.1% (32.9-33.4%) for in-hospital, 30-day and 1-year mortality after the index admission. Age, sex and ethnicity-adjusted 30-day readmissions increased by 2% per calendar year while in-hospital and 30-day mortality declined by 7% and 4% per year respectively. One-year mortality rates remained constant during the study period. Men were at higher risk of 30-day readmission (adjusted rate ratio (RR) 1.16, 1.13-1.20) and one-year mortality (RR 1.17, 1.15-1.19) than women. Ethnic differences in outcomes were evident. Readmission rates were equally high in Chinese and Indians relative to Malays whereas Others, which mainly comprised Indigenous groups, fared worst for in-hospital and 30-day mortality with RR 1.84 (1.64-2.07) and 1.3 (1.21-1.41) relative to Malays. Conclusions: Short-term survival was improving across sex and ethnic groups but prognosis at one year after incident HF hospitalisation remained poor. The steady increase in 30-day readmission rates deserves further investigation.
KW - ethnicity
KW - heart failure
KW - outcomes
KW - trends
UR - http://www.scopus.com/inward/record.url?scp=85128435057&partnerID=8YFLogxK
U2 - https://doi.org/10.5334/gh.1108
DO - https://doi.org/10.5334/gh.1108
M3 - Article
C2 - 35342695
SN - 2211-8160
VL - 17
SP - 20
JO - Global Heart
JF - Global Heart
IS - 1
M1 - 20
ER -