SPC365

Trends in cardiovascular hospital admissions over the last 15 years: is it time to rethink healthcare policies?

Session: SESSÃO DE COMUNICAÇÕES ORAIS 03 - EPIDEMIOLOGIA E ORGANIZAÇÃO DE CUIDADOS DE SAÚDE
Speaker: Helena Sofia Santos Moreira

Congress: CPC 2025
Topic: N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme: 34. Public Health and Health Economics
Subtheme: 34.1 Public Health
Session Type: Comunicações Orais
FP Number: ---
Authors: Helena Sofia Santos Moreira; Miguel Rocha; Pedro Mangas Palma; Ana Isabel Pinho; Cátia Oliveira; Luís Santos; Emanuel Oliveira; Joana Gonçalves; Bernardo Cruz; Rui André Rodrigues; Ana Lebreiro

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"> The field of cardiovascular (CV) diseases has witnessed significant changes in recent years, marked by cutting-edge scientific advancements with novel diagnostic approaches and clinical entities. Understanding trends in CV hospital admissions is essential to improve&nbsp;healthcare policies,</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">&nbsp;as it remains the leading cause of morbidity and mortality worldwide.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><strong>Purpose:</strong> To analyse the 15-year trends in the CV profile of patients (pts) admitted to the cardiology department of a tertiary center.</span></span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"> A retrospective analysis was conducted on pts admitted to the cardiology ward of our centre between 2008 and 2023. Data on baseline characteristics and index events were collected through medical records review. Linear regression was performed to evaluate time trends.</span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Results:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"> A total of 14304 pts were included, with 80.2% (n=11470) representing urgent admissions. Bed capacity increased significantly over the study period, resulting in an annual mean rise of 75 admissions (R<sup>2</sup> = 0.77; P &lt; 0.001), doubling from 849 in 2008 to 1713 in 2023.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Focusing on urgent admissions, 68% were male (n= 7825), though the proportion of females increased annually by 0.48% (R<sup>2</sup> = 0.54; p &lt; 0.004), comprising 39% of the pts in 2023. Mean a</span></span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">ge rose by 0.26 years annually&nbsp; (R<sup>2</sup> = 0.68; p &lt; 0.001), with pts having 65 &plusmn; 15 years in 2023. </span></span><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Arterial hypertension (62.6%) and dyslipidemia (61.3%) were the most common CV risk factors, with no substantial variation over time. Acute coronary syndrome (ACS) was the most frequent diagnosis (n=6684, 58.3%), though its proportion declined 2.3% annually (R<sup>2</sup> = 0.76; p &lt; 0.001), reflecting the emergence of other diagnosis &ndash; figure 1. Urgent admissions due to rhythm disturbances increased significantly, with a 0.58% annual rise (R<sup>2</sup>=0.72; p= 0.001), particularly over the past 10 years (2014: 9.99% vs. 2023: 18.08%). Also, admissions for heart failure nearly doubled since the beginning of the decade (2010: 4.9% vs 2023: 8.6%), with overall a&nbsp;yearly increase of 0.29% (R<sup>2</sup>=0.35; p=0.033). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Hospitalizations due to severe aortic stenosis are currently nine times more prevalent (2008: 1.5% vs. 2023: 13.7%), with a 0.78% annual rise (R<sup>2</sup>=0.80; p&lt;0.001), largely driven by elective admissions for transcatheter aortic valve implantation (TAVI). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">The median duration of hospitalizations was 6 (IQR 5) days, with a non-significant trend towards shorter stays (p=0.11) over the years. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Conclusion:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"> Our study highlights the dynamic nature of CV health, including an aging population, an increasing proportion of female pts and rising admissions for arrhythmias, heart failure&nbsp;and severe aortic stenosis. These findings underscore the need for tailored strategies and resource adaptation to address the growing burden of CV diseases. Further research is required to guide institutional and national healthcare policies in response to these trends.</span></span></span></span></p>