Dr Kao said: “These findings confirm the huge decline in mortality in hospitals for heart failure over the past 14-15 years following major advances in therapy.”
Daily heart failure admissions peaked in February (p
Numerous theories have been mooted for the cause of seasonal variations in heart failure morbidity and mortality, for example that the holiday spike is caused by alcohol and drug use.
Dr Kao said: “For the first time we’ve shown that there wasn’t a higher rate of alcohol and drug use reported in heart failure patients during December and January, when heart failure mortality was the highest.”
Seasonal variations affected rate of heart failure hospitalization and mortality in patients over the age of 30, and the effect was greater with advancing age. An increase in concurrent pneumonia in the winter could impact on heart failure mortality, but there was less seasonal variation in other respiratory diseases like chronic obstructive pulmonary disease (COPD).
The findings suggest that staffing may have an impact on seasonal variations in mortality and length of stay. Dr Kao said: “The fact that patients admitted right before the weekend and in the middle of the night do worse and are in hospital longer suggests that staffing levels may contribute to the findings.”
He added: “The seasonal effect on in-hospital death from heart failure remained even after controlling for time and weekday of admission, 17 other medical conditions including substance use, kidney disease, and pneumonia, and demographic factors including gender, ethnicity, and medical coverage status. Seasonal variations in morbidity and mortality occur in many diseases, particularly heart disease, and the cold weather itself may have a part to play.”
Dr Kao concluded: “Doctors and hospitals need to be more vigilant during these higher risk times and ensure that adequate resources are in place to cope with demand. Patients should be aware that their disease is not the same over the course of the year and they may be at higher risk during the winter. People often avoid coming into hospital during the holidays because of family pressures and a personal desire to stay at home but they may be putting themselves in danger.”
Authors: ESC Press Office
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About the European Society of Cardiology (ESC)
The European Society of Cardiology (ESC) represents more than 80,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About the Heart Failure Association (HFA)
The Heart Failure Association (HFA) is a registered branch of the ESC. Its aim is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
For practical information about heart failure aimed at patients, families and caregivers, visit the HFA’s Heart Failure Matters website.
About press registration
On-site registration opens 25 May 2013 in Lisbon supported by presentation of a press card or letter of assignment with proof of 3 published articles together with the filled in and signed embargo form 2013.
- Heart Failure 2013
- Kao DP, Mcilvennan CK, Page RL, et al. Impact of day, month and hour of admission on inpatient outcomes in 949.907 hospitalizations for congestive heart failure, Presented at Heart Failure Congress 2013 Final Programme Number P1230.