RECURRENT HEART FAILURE HOSPITALIZATIONS IN FRANCE: BURDEN AND PREDICTORS FROM A NATIONWIDE COHORT STUDY (PATHOS STUDY)
Author(s)
Jana Boleckova, PhD1, Shannon Murphy, MA2, Jens Deckert, MSc3, Aurélie Schmidt, MSc4, Hugo Tircazes, -4, Benjamin Grenier, MSc, PharmD4, Alice Brouquet, MSc4, Rachele Busca, MBA, MSc, PharmD5.
1Edwards Lifesciences Sàrl, Prague, Czech Republic, 2Edwards Lifesciences, Irvine, CA, USA, 3Edwards Lifesciences Sàrl, Opfikon, Switzerland, 4Heva, Lyon, France, 5Edwards Lifesciences Sàrl, Nyon, Switzerland.
1Edwards Lifesciences Sàrl, Prague, Czech Republic, 2Edwards Lifesciences, Irvine, CA, USA, 3Edwards Lifesciences Sàrl, Opfikon, Switzerland, 4Heva, Lyon, France, 5Edwards Lifesciences Sàrl, Nyon, Switzerland.
OBJECTIVES: To describe patients hospitalized for heart failure (HF) in France, characterize HF index stays and identify factors associated with HF rehospitalization
METHODS: This retrospective cohort study used the French nationwide hospital discharge database (PMSI) of adults with a HF hospitalization in 2021. Patients and stays characteristics were described. Factors associated with recurrent rehospitalization through December 31, 2024 were assessed using multivariable Andersen-Gill models.
RESULTS: A total of 180,304 patients was identified with a median follow-up time (IQR) of 37.8 (33.4) months. Median age at baseline was 83.0 (15.0) and 50.8% were males. Median Charlson comorbidity index was 7.0 (2.0). Most frequent comorbidities were hypertension (75.5%), rhythm/conduction disorders (72.8%) and chronic kidney disease (34.4%). Overall, 28.8% of patients had at least one HF stay in the 6-year look-back period and 2.2% had 5+. Mean (SD) index HF stay duration was 9.6 (8.12) days. 21.6% of the patients experienced ICU care during their stay with a mean duration of 5.2 (6.01) days. Patients were most frequently discharged home (71.2%), 21.0% were transferred to another hospital or care facility and 7,8% died in hospital. Median reimbursed amounts (in €2024) of the index and subsequent stays were €4,259 (2,346) and €4,555 (1,985), respectively. Among patients at risk of rehospitalization (n=165,030), 26.0% experienced at least one rehospitalization at 12 months and 38.5% at the end of the follow-up. Key predictors of subsequent HF rehospitalization were prior HF stays in the look-back period (HR 1.54 and 2.82 respectively for 1 and 5+ stays vs 0) and a Charlson score >5 (HR 1.41; for a score >5 vs 1-2).
CONCLUSIONS: HF hospitalization is associated with substantial multimorbidity, long inpatient stays, frequent transfer to post-acute care, and early recurrence. Previous HF hospitalizations are a main driver of future readmissions, highlighting the need for intensified follow-up and care coordination after discharge.
METHODS: This retrospective cohort study used the French nationwide hospital discharge database (PMSI) of adults with a HF hospitalization in 2021. Patients and stays characteristics were described. Factors associated with recurrent rehospitalization through December 31, 2024 were assessed using multivariable Andersen-Gill models.
RESULTS: A total of 180,304 patients was identified with a median follow-up time (IQR) of 37.8 (33.4) months. Median age at baseline was 83.0 (15.0) and 50.8% were males. Median Charlson comorbidity index was 7.0 (2.0). Most frequent comorbidities were hypertension (75.5%), rhythm/conduction disorders (72.8%) and chronic kidney disease (34.4%). Overall, 28.8% of patients had at least one HF stay in the 6-year look-back period and 2.2% had 5+. Mean (SD) index HF stay duration was 9.6 (8.12) days. 21.6% of the patients experienced ICU care during their stay with a mean duration of 5.2 (6.01) days. Patients were most frequently discharged home (71.2%), 21.0% were transferred to another hospital or care facility and 7,8% died in hospital. Median reimbursed amounts (in €2024) of the index and subsequent stays were €4,259 (2,346) and €4,555 (1,985), respectively. Among patients at risk of rehospitalization (n=165,030), 26.0% experienced at least one rehospitalization at 12 months and 38.5% at the end of the follow-up. Key predictors of subsequent HF rehospitalization were prior HF stays in the look-back period (HR 1.54 and 2.82 respectively for 1 and 5+ stays vs 0) and a Charlson score >5 (HR 1.41; for a score >5 vs 1-2).
CONCLUSIONS: HF hospitalization is associated with substantial multimorbidity, long inpatient stays, frequent transfer to post-acute care, and early recurrence. Previous HF hospitalizations are a main driver of future readmissions, highlighting the need for intensified follow-up and care coordination after discharge.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH2
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Disease Classification & Coding, Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas