Epidemiology of heart failure and feasibility of home care in patients with worsening chronic heart failure

Aim: To investigate gender-specific trends in long-term mortality in patients hospitalised for ischaemic and non-ischaemic heart failure (HF) and explore temporal trends in the risk of HF complicating acute myocardial infarction (AMI). Another aim is to characterise patients with chronic heart failure (CHF) that seek an emergency department (ED) because of their deteriorating condition and evaluate the feasibility of home care (HC) in comparison with conventional care (CC) in patients with worsening CHF. Patients and methods: In Papers I and II, data from the national hospital discharge and cause-specific death registers were linked through the personal identity number. The hospital discharge register has been in operation since the 1960s and has operated on a nationwide basis since 1987. Between April 2004 and May 2006, patients seeking care for dyspnoea were identified at the ED at Sahlgrenska University Hospital/Östra, Göteborg, Sweden. From this population, patients with known CHF were registered and further investigated on gender, age, socio-economic status, heart rate, blood pressure and symptoms and signs of HF. The information was saved in a registry. These data were subsequently used in Papers III and IV. Results: Long-term mortality decreased, mainly during 1987–1995, with no further decrease after 2001. Survival improved more in men than in women, particularly in patients aged