Incidence and hospital death rates associated with heart failure: A community-wide perspective

PURPOSE: Despite often stated references to the emerging epidemic of heart failure in the United States, relatively little data are available describing the incidence and short-term death rates associated with this clinical syndrome. The objectives of this study were to describe the hospital incidence and death rates associated with acute heart failure and factors associated with an adverse hospital prognosis in residents of the Worcester, Mass, metropolitan area hospitalized at all greater Worcester medical centers with new onset heart failure in 2000. SUBJECTS AND METHODS: We reviewed the medical records of patients hospitalized for acute heart failure at all 11 area medical centers during 2000. New onset heart failure was diagnosed using standardized criteria. Regression analyses were performed to examine demographic and clinical factors associated with hospital death rates. RESULTS: During 2000, 2604 men and women from greater Worcester were diagnosed with new onset heart failure; 637 (24.5%) of these cases were initial events. The incidence and attack rates (per 100,000) of heart failure were 219 and 897, respectively. Occurrence of heart failure increased with advancing age, and women were at greater risk for heart failure than men (incidence rates [per 100,000] = 250 and 194, respectively). Hospital case-fatality rates were 5.1%. Hospital death rates were associated with several demographic and clinical characteristics. CONCLUSIONS: The results of this study suggest that heart failure is an important clinical syndrome affecting residents of this large northeast community. Several groups at high risk for developing or dying from heart failure can be identified and targeted for preventive efforts as well as for the receipt of effective treatment modalities.