Abstract 10314: The Epidemiology of Valvular Heart Diseases: Incidence Growing
Background: Valvular heart disease (VHD) is among the most predictable causes of heart failure and an important cause of sudden death. Temporal trends of clinically significant VHD during the past few decades have not been defined.
Methods: To obtain information for our region, we conducted a longitudinal analysis of 66,770,276 inpatient hospitalizations obtained from New York State's (NYS) Statewide Planning and Research Cooperative System (SPARCS) database for years 1983 through 2007 (last year for which data are reliable). All VHD cases were identified from principal or secondary ICD-9 codes for aortic, mitral, tricuspid or pulmonic VHD (n=1,882,504). Linear regression was used to evaluate trends over time for VHD hospitalizations, therapeutic invasive procedures and in-hospital mortality. Logistic regression was used to determine predictors of in-hospital deaths.
Results: During 25 years, total hospitalizations decreased from 3,032,235 cases (1983) to 2,628,545 cases (2007); simultaneously, VHD hospitalizations increased markedly (33,679 in 1983 to 110,029 in 2007). Rate of increase was linear across all VHD categories = 3,213 cases (9.1%)/yr (r2 = 0.977, p<.001). The trend was similar for invasive therapeutic valve procedures (2,756 in 1983 to 8,122 in 2007), linearized rate of increase = 261 procedures (7.8%)/yr (r2=.980, p<.001). Both hospitalization and procedure rates increased (p<.001) with age. Inpatient death occurred in 100,296 VHD cases. Although the number of deaths increased from 1,920 in 1983 to 5,147 in 2007, increase in VHD patients resulted in stability of in-hospital death rate during the study interval (about 5.3% per year). These deaths were independently associated with advancing age, non-elective admission, male gender and presence of associated heart failure.
Conclusions: The incidence of VHD hospitalization and treatment in NYS has progressively and constantly risen since the early 1980s. The relatively constant growth curves can be expected to continue since the VHD inpatient population is projected to increase as the state's population ages. These findings suggest intensive planning for dealing with public health implications of the increase as we attempt to meet the growing needs of this patient population.
- © 2010 by American Heart Association, Inc.