Analysis of mortality among patients suffering from heart failure, using the example of a megalopolis

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Abstract

The medical documentation (n = 146912) introduced into the system “Regional fragment of the unified state information system in the field of healthcare” of Saint Petersburg for 2019–2021 was analyzed. To evaluate the mortality of patients due to heart failure, all deceased patients from 2019 to 2021 in Saint Petersburg (n = 192133) were taken as a basis, and based on a thorough study of medical documentation, patients who died from cardiovascular diseases and because of heart failure were singled out separately. The total mortality from all causes in Saint Petersburg in 2019 was 53025 people; in 2020, 66468 people; and in 2021, 72640 people. The analysis of mortality due to cardiovascular diseases from 2019 to 2021 showed an upward trend of 20.1% over the 3-year period of data analysis. When analyzing the prevalence of heart failure among deceased patients, an increase of 129.4% was noted over this period. The obtained results of the prevalence, mortality, and mortality of patients due to heart failure on the example of a megalopolis are the most relevant at the current time; they indicate a steady increase in the number of patients suffering from heart failure with an increase in the burden on the city’s healthcare system. Simultaneously, there is insufficient continuity in the provision of medical care to patients suffering from heart failure, which is because of not only a shortage of medical personnel at all stages of medical care but also insufficient compliance of patients who either do not want to be treated or cannot continue treatment. Moreover, a significant disconnect was found in the continuity of medical care at the stages of pre-hospital and hospital treatment, as well as further outpatient follow-up of patients suffering from heart failure in the metropolis. All this leads to a significant increase in the mortality and mortality of patients suffering from heart failure, despite all the existing modern effective drug therapies. It appears critical to create a unified register platform for recording patients with heart failure, which will allow for a more accurate understanding of epidemiological aspects, the solution of which will improve the quality of medical care, identify the need for the crucial medicines, and reduce mortality, and mortality rates due to heart failure.

About the authors

Andrew V. Koltsov

Kirov Military Medical Academy

Author for correspondence.
Email: Andrewkoltsov83@gmail.com
ORCID iD: 0000-0001-9881-4587
SPIN-code: 8988-4988

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vadim V. Tyrenko

Kirov Military Medical Academy

Email: vadim_tyrenko@mail.ru
ORCID iD: 0000-0002-0470-1109
SPIN-code: 3022-5038

MD, Dr. Sci. (Med.), professor

Russian Federation, Saint Petersburg

Vasilii A. Kachnov

Kirov Military Medical Academy

Email: kvasa@mail.ru
ORCID iD: 0000-0002-6601-5366
SPIN-code: 2084-0290

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

References

  1. Polyakov DS, Fomin IV, Belenkov YuN, et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14. (In Russ.). doi: 10.18087/cardio.2021.4.n1628
  2. Ageev FT, Danielyan MO, Mareev VYu, Belenkov YuN. Bol’nye s khronicheskoi serdechnoi nedostatochnost’yu v rossiiskoi ambulatornoi praktike: osobennosti kontingenta, diagnostiki i lecheniya (po materialam issledovaniya EHPOKHA-O-KHSN). Russian heart failure journal. 2004;5(1):4–7. (In Russ.).
  3. Fomin IV, Belenkov YuN, Mareev VYu, et al. Prevalence of chronic heart failure in the European part of the Russian Federation: data from EPOCH-CHF. Russian heart failure journal. 2006;7(1):112–115. (In Russ.).
  4. Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020;25(11):311–374. (In Russ.). doi: 10.15829/1560-4071-2020-4083
  5. Koltsov AV, Tyrenko VV, Sarana AM, et al. Prevalence of Heart Failure in a Megalopolis. Kardiologiia. 2022;62(12):50–56. (In Russ.). doi: 10.18087/cardio.2022.12.n229

Supplementary files

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2. Fig. 1. Mortality in Saint Petersburg from 2019 to 2021

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3. Fig. 2. Annual mortality from the moment of hospitalization due to heart failure in Saint Petersburg

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4. Fig. 3. Annual mortality from the time of hospitalization because of heart failure in Saint Petersburg (n = number of hospitalized patients)

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5. Fig. 4. Annual mortality from the moment of hospitalization because of heart failure in Saint Petersburg for 2020, considering the time of death

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6. Fig. 5. Annual mortality from the moment of hospitalization due to heart failure in Saint Petersburg for 2021, considering the time of death

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7. Fig. 6. Annual mortality from the moment of hospitalization due to heart failure and hypertension

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8. Fig. 7. Annual mortality from the moment of hospitalization due to heart failure and myocardial infarction

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9. Fig. 8. Annual mortality from the moment of hospitalization due to heart failure and coronary heart disease

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10. Fig. 9. Annual mortality from the moment of hospitalization due to heart failure and atrial fibrillation

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11. Fig. 10. Annual mortality from the moment of hospitalization due to heart failure and acute cerebrovascular accident

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12. Рис. 1. Смертность в Санкт-Петербурге в период с 2019 по 2021 г.

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13. Рис. 2. Годовая летальность от момента госпитализации по причине СН в Санкт-Петербурге

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14. Рис. 3. Годовая летальность от момента госпитализации по причине СН в Санкт-Петербурге (n = количество госпитализированных пациентов)

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15. Рис. 4. Годовая летальность от момента госпитализации по причине СН в Санкт-Петербурге за 2020 г. с учетом времени наступления летального исхода

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16. Рис. 5. Годовая летальность от момента госпитализации по причине СН в Санкт-Петербурге за 2021 г. с учетом времени наступления летального исхода

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17. Рис. 6. Годовая летальность от момента госпитализации по причине СН и ГБ

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18. Рис. 7. Годовая летальность от момента госпитализации по причине СН и ИМ

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19. Рис. 8. Годовая летальность от момента госпитализации по причине СН и ИБС

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20. Рис. 9. Годовая летальность от момента госпитализации по причине СН и ФП

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21. Рис. 10. Годовая летальность от момента госпитализации по причине СН и ОНМК

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Copyright (c) 2023 Koltsov A.V., Tyrenko V.V., Kachnov V.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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