OBJECTIVES: Heart failure (HF) imposes an enormous burden on individuals and society, being among leading causes of hospitalization in Canada, particularly among the elderly. Given that burden, there is a remarkable paucity of contemporary information on the epidemiology of HF in Canada. The objective of this study was to determine occurrence, hospitalization and mortality from HF in the province of Nova Scotia.

METHODS: A retrospective cohort study was conducted using population-based administrative health databases, including hospital discharge abstracts and outpatient physician billing from Nova Scotia (2014 population 922,000). The cohort consisted of adults with a newly-coded International Classification of Diseases diagnosis of HF between April 2011 and March 2013 and followed until March 2014. Outcomes included incidence, prevalence, and one-year mortality and readmission after an initial hospitalization for HF.

RESULTS: During the study period, 12,597 persons had at least one hospitalization for HF. In 2012-2013, the annual incidence per 100,000 was 274 among women and 287 among men and the prevalence per 100,000 was 980 among women and 1068 among men. Following an initial hospitalization for HF, the median survival was 3.2 years (95% CI 3.1-3.3). At one year, mortality was 29% (95% CI 28%-30%), and 35% (95% CI 34%-36%) were re-hospitalized and 51% (95% CI 50%-52%) experienced the combined endpoint of either re-hospitalization or death.

CONCLUSIONS: HF continues to be among the most common and progressively virulent conditions afflicting Canadians. Nova Scotia data from the late 1990’s showed one-year mortality of 29%, 31% re-hospitalization and 51% with the combined endpoint. The lack of improvement – and possible deterioration – in the natural history highlights the lack of progress in treating HF in Canada.