Heart failure & cardiomyopathiesCohort study
Health Care Use and Outcomes in Heart Failure
- Retrospective cohort study using interrupted time series (ITS)
- adjusted for age, sex, socioeconomic status, comorbidity burden, seasonality, and pre-pandemic trends
Authors' conclusion
The declines in hospitalizations and ED visits seen during the pandemic continued post-pandemic, severity of presentation increased, and the decline in non-COVID mortality rates was consistent with pre-pandemic trends.
Study context
- Population
- Patients with heart failure (HF), March 2018 to May 2024patients per period · pre-pandemic 66,782 · intra-pandemic 77,473 · post-pandemic 82,072
- Participants
- 66,782 / 77,473 / 82,072
- Exposure
- monthly rates of mortality, hospitalizations, emergency department (ED) visits, and ambulatory care visits in patients with HF pre-pandemic, intra-pandemic, and post-pandemic
- pre-pandemicn = 66,782reference
- intra-pandemicn = 77,473
- post-pandemicn = 82,072
Main finding
As reported in the abstract
Canadian Triage Acuity Scores in patients with HF presenting to an ED or being hospitalized
More severe Canadian Triage Acuity Scores during and post-pandemic than pre-pandemic (both P < 0.001)
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Incidence rate ratio | |
|---|---|---|
| All-cause hospitalizations (monthly) · median follow-up 2.9 years (IQR: 1.1-5.9 years) — intra-pandemic vs pre-pandemic · lower during pandemic · adjusted for covariates and pre-pandemic trends | 0.83 (95% CI 0.81–0.86) | |
| All-cause hospitalizations (monthly) · median follow-up 2.9 years (IQR: 1.1-5.9 years) — post-pandemic vs pre-pandemic · lower post-pandemic · adjusted for covariates and pre-pandemic trends | 0.81 (95% CI 0.78–0.84) | |
| All-cause ED visits (monthly) · median follow-up 2.9 years (IQR: 1.1-5.9 years) — intra-pandemic vs pre-pandemic · lower during pandemic · adjusted for covariates and pre-pandemic trends | 0.81 (95% CI 0.78–0.84) | |
| All-cause ED visits (monthly) · median follow-up 2.9 years (IQR: 1.1-5.9 years) — post-pandemic vs pre-pandemic · lower post-pandemic · adjusted for covariates and pre-pandemic trends | 0.84 (95% CI 0.80–0.89) | |
| Non-COVID mortality rates · lower post-pandemic | 0.58 (CI 0.53–0.63) | |
| 0.512Incidence rate ratio (log scale) |
- All-cause hospitalizations (monthly): ITS P = 0.001
- All-cause ED visits (monthly): ITS P = 0.005
- Non-COVID mortality rates: ITS analysis: not a significant departure from pre-pandemic trends (P = 0.79)
Original publication
Health Care Use and Outcomes in Heart Failure. JACC Adv. Published 10 July 2026. doi:10.1016/j.jacadv.2026.102986
Summarised from the published abstract; every number is checked against it