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Epidemiology of chronic heart failure in Germany: a retrospective study of the health risk institute healthcare claims database

Session Poster Session 4

Speaker Stefan Stoerk

Event : Heart Failure 2016

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : F Calado (Basel,CH), S Stork (Wuerzburg,DE), S Klebs (Nuernburg,DE), R Lahoz (Basel,CH), R Handrock (Nuernburg,DE), J Jacob (Berlin,DE), J Walker (Berlin,DE), S Hupfer (Nuernburg,DE)

Authors:
F Calado1 , S Stork2 , S Klebs3 , R Lahoz1 , R Handrock3 , J Jacob4 , J Walker4 , S Hupfer3 , 1Novartis Pharma AG - Basel - Switzerland , 2University of Wuerzburg, Department of Internal Medicine I, Cardiology - Wuerzburg - Germany , 3Novartis Pharma GmbH - Nuernburg - Germany , 4Elsevier - Berlin - Germany ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 462

Background: Chronic heart failure (CHF) is associated with significant healthcare expenditure, morbidity and mortality. Nationwide CHF registries in Germany are lacking. Therefore, a retrospective study of healthcare claims data from the Health Risk Institute (HRI) was conducted. Purpose: We aimed to estimate the incidence and prevalence of CHF in Germany and associated frequency of hospitalization, and morbidity and mortality. Methods: The HRI database contains anonymized data from approximately 7 million individuals with statutory health insurance in Germany. From this data set an age- and sex-stratified subset of 4 million people was drawn. Eligible patients for the present analysis had uninterrupted data from 1 Jan 2009 to 31 Dec 2013. Data from patients with at least two recorded CHF-related diagnoses based on ICD-10 German Modification codes for CHF in a hospital or ambulatory setting in 2011 were analysed. Furthermore, a subgroup of patients with newly diagnosed CHF was identified based on the absence of a CHF diagnosis in the year before first diagnosis in 2011. All patients were followed for 2 years after first CHF diagnosis in 2011. Results: Of 3 132 337 eligible patients, 3.96% (n = 123 925; mean age 76.2 years, 55.2% women) had CHF in 2011 and were included in the study, corresponding to an estimated prevalence of 3.87% in Germany. Out of those, a subgroup of 26 368 patients had newly diagnosed CHF, corresponding to an incidence of 655 per 100 000 persons at risk in Germany. The number of new CHF cases increased with age, and was similar in women and men. In the 2-year follow-up period, there were 48 159 hospitalizations among patients with newly diagnosed CHF; heart failure was the most common reason specified for hospitalization (7.5%). The most common comorbidities in the newly diagnosed CHF subgroup were primary hypertension (81.7%), dyslipidaemia (50.4%) and chronic ischaemic heart disease (44.4%). In the 2-year follow-up period, 16.3% (n = 20 148) of all patients with CHF had died. In the same period, there were 5983 deaths in the newly diagnosed CHF subgroup (22.7%). Mortality was similar in women (22.6%) and men (22.8%), and increased with New York Heart Association class (14.6%, 16.9%, 30.8% and 53.3% for classes I, II, III and IV, respectively). Conclusions: The high prevalence and incidence of CHF observed in this study underline the burden of CHF in Germany. Substantial mortality and hospitalization rates highlight the need for earlier diagnosis and appropriate treatment.

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