Influence of concomitant disease on patterns of hospitalization in patients with heart failure discharged from Scottish hospitals in 1995

AIMS: To determine the prevalence of common, serious, concomitant conditions complicating admissions with heart failure and how such conditions influence the length of hospital stay. METHODS AND RESULTS: Data from Scottish morbidity records (SMR1) were used to determine the rate of deaths and discharges for heart failure (ICD-9 428.0, 428.9), concomitant discharge diagnoses and length of stay in 1995. 27,477 SMR1 records listing heart failure as a diagnosis were identified with heart failure in the first position in 11,560 (42%) records. 63.3% of deaths or discharges results from emergency admission. 13.2% of admissions were associated with acute myocardial infarction, 7.3% with angina or chest pain, 11.8% with chronic airways obstruction, 8.3% with chronic or acute renal failure and 5.3% had had a stroke. Length of stay including those patients who died was 7.6 days when acute myocardial infarction was the principal diagnosis but 26.3 days when stroke was the principal diagnosis. CONCLUSION: A large proportion of deaths and discharges for heart failure are associated with conditions other than heart failure that may precipitate, contribute to or complicate admission. Treatment for heart failure that does not also seek to reduce the risk associated with common concomitant diseases may miss opportunities to reduce the overall risk of hospitalization.