Heart failure & cardiomyopathies
Characteristics and Outcomes of Heart Failure in Japan: A Hospital-Based Administrative Database Analysis
Authors' conclusion
The proportion of patients in each HF category was largely consistent with existing data. Discharge medications indicated high prescription of guideline-directed therapy.
Study context
- Population
- Patients hospitalised with a primary diagnosis of heart failure (HF) in Japan (Voluntary Hospitals in Japan (VHJ) hospitals), 1 April 2017–30 March 20207,212 analysed
- Participants
- 10,646 patients
- Exposure
- HF with Reduced EF (HFrEF) vs HF with Mildly Reduced EF (HFmrEF) vs HF with Preserved EF (HFpEF)
- HFpEFn = 3,183
- HFmrEFn = 1,280
- HFrEFn = 2,749
- Outcome
- Distribution of HF categories by baseline LVEF
Methodological detailsnon-interventional, administrative claims and electronic medical records database, 17 VHJ hospitals
- Non-interventional
- Administrative claims and electronic medical records database
- 17 VHJ hospitals
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HFpEF | HFmrEF | HFrEF |
|---|---|---|---|
| ACEi use at discharge | 20.6% (95% CI 19.2–22.1) | 27.5% (95% CI 25.1–30.0) | 40.6% (95% CI 38.7–42.4) |
| ARB use at discharge | 31.2% (95% CI 29.6–32.9) | 32.5% (95% CI 29.9–35.1) | 25.1% (95% CI 23.5–26.8) |
- ACEi use at discharge: P < 0.0001
- ARB use at discharge: P < 0.0001
Beta-blocker use, before admission vs at discharge (all patients)
- Before admission
- 23.3% (95% CI 22.3-24.3)
- At discharge
- 69.4% (95% CI 68.3-70.5)
- Diuretics, ACEi and ARBs showed a similar trend
Length of hospitalisation (all patients)
- Mean (SD 23.3), days
- 22.2
- Median (IQR 11-25), days
- 17
Cost per patient during index hospitalisation
- Estimated average HF treatment cost (highest in HFrEF)
- 300 090 yen
- Average total healthcare expenditure (highest in HFrEF)
- 1 225 650 yen
Re-hospitalisation for HF and mortality (exploratory) · mean (SD) observation 324 (304) days
- Re-hospitalisation for HF, each group
- ≈21%
- Deaths
- 625 (8.7%)
- Exploratory analysis
Original publication
Characteristics and Outcomes of Heart Failure in Japan: A Hospital-Based Administrative Database Analysis. ESC Heart Fail. Published 3 September 2024. doi:10.
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