Administrative data-based retrospective study of patients with heart failure and other comorbidities, diagnosed between 2012 and 2020

Abstract

Heart failure is a widespread condition affecting more than 23 million people globally, with an increasing year-by-year prevalence due to the aging population, despite continuous development of new therapeutic options. This research seeks to answer how the occurrence of comorbidities, which are typically prevalent among heart failure patients, change in the analysed patient population and to what extent these diseases contribute to the development of heart failure.

The analysis was based on multiple databases, such as the inpatient and outpatient healthcare utilization data and demographic data from the TAJ database. By linking these databases, we conducted trend analysis and multivariable logistic regression analysis on the data of patients with diagnosed heart failure between 2012 and 2020 while examining their demographic characteristics.

Said heart failure population in Hungary is highly multimorbid and various diseases are simultaneously contributing to the deterioration of health. We found that compared to the 40-49 age group, the 50-59 age group had a 1.848 times higher, the 60-69 age group had a 2.500 times higher, and the 70-79 age group had a 3.121 times higher chance of developing heart failure. In terms of counties, we did not find any significant differences. The highest risk for developing heart failure was observed among patients with acute myocardial infarction within the previous year (9.247 times higher). The risk of developing heart failure was 7.377 times higher for cardiomyopathy, 4.127 times higher for hypertension, 3.070 times higher for COPD, 2.839 times higher for kidney failure, 2.836 times higher for ischemic heart disease, 2.731 times higher for atrial fibrillation, 2.151 times higher for arrhythmia, and 1.507 times higher for diabetes.

Based on our analysis of administrative data, scientifically known risk factors also become highlighted. All of these underline the importance of prevention and screening so that patients with known morbidities can start treatments in the early stages of heart failure; thereby, maximizing their life expectancy. In terms of comorbidities, significant differences were observed between the heart failure population and the control group. In the control group, comorbidities occur less frequently, regardless of the level of healthcare utilization, compared to the heart failure population. However, within the heart failure population, the proportion of comorbidities increased with age. In 2020, a decrease was observed for several comorbidities, which can most likely be explained by the Covid19 pandemic.

To the best of our knowledge, no study covering almost 10 years and processing such a large number of patients has been published. Our study confirmed the results of previous studies regarding the risk factors and comorbidities of heart failure. Additionally, based on the logistic regression results, we weighted the risk factors, thereby determining the order of preventive measures.