Trends in Heart Failure: Going in the Right Direction?

This article refers to ‘Heart failure epidemiology 2000–2013: insights from the German Federal Health Monitoring System’, by M. Christ et al., published in this issue on pages 1009–1018. Heart failure (HF) is a complex syndrome affecting several million patients worldwide. Reducing the heavy burden of HF is a priority for health-care systems and the society. Therefore, monitoring trends in HF is needed to evaluate how well current health organizations and policies are dealing with this challenge. Christ et al. 1 present in this issue of the European Heart Failure Journal the analysis of all hospitalizations for HF as main diagnosis registered in Germany during the first 14 years of this century. The study shows that, with nearly 400 000 admissions, HF was the leading cause of hospitalization in Germany in year 2013, accounting for 2.1% of all hospitalizations and, with 4.2 million days, for 2.9% of all hospital stays. During the study period, HF-related hospitalizations showed a disproportionate growth compared with hospitalizations for all causes, the greatest being seen in the segment of patients over 75 years of age, paralleling the demographic changes observed in recent years. However, age-standardization only attenuated the increase, suggesting that population ageing only partly explains these trends. In-hospital mortality rates among HF patients dropped from 14.8% in 2000 to 9.3% in 2013, a trend consistent with previous reports from other countries,2–5 but still accounting for nearly 37 000 hospital deaths in 2013. The clinical impact of these figures is huge but the economical implications are astronomical.