TY - JOUR
T1 - Cardiovascular events, mortality, early retirement and costs in >50 000 persons with chronic heart failure in Sweden
AU - Steen Carlsson, Katarina
AU - Faurby, Mads
AU - Nilsson, Kristoffer
AU - Wolden, Michael Lyng
PY - 2024/2
Y1 - 2024/2
N2 - Aims: We aimed to examine cardiovascular events (stroke and myocardial infarction [MI]), mortality, early retirement and economic costs over 5 years in people with chronic heart failure (CHF) and matched controls in Sweden. Methods and results: Individuals (aged ≥16 years) living in Sweden on 1 January 2012 were identified in an existing database. Individuals with CHF were propensity score matched to controls without CHF by birth year, sex and educational status. We analysed risks of stroke, MI, mortality and early retirement, and compared direct costs (inpatient care, outpatient care and drug costs) and indirect costs (work absence). After matching, there were 53 520 individuals in each cohort. In each cohort, mean age was 69.0 years (standard deviation 8.2), and 29.7% of individuals were women. People with CHF were significantly more likely than controls to experience stroke (hazard ratio 1.46 [95% confidence interval 1.38–1.56]) and MI (1.61 [1.51–1.71]). All-cause mortality was nearly three-fold higher (2.89 [2.80–2.98]) and the likelihood of early retirement was more than three-fold higher (3.69 [3.08–4.42]). Total mean annual costs per person were €9663 (standard error 38) for people with CHF, of which 53% were direct costs, and €2845 (standard error 19) for controls, of which 40% were direct costs. In people with CHF, inpatient costs comprised 78% of total annual mean direct costs over follow-up, outpatient costs contributed 15% and drug costs contributed 8%. In controls, the corresponding proportions were 71%, 18% and 11%. Conclusions: CHF has a considerable impact on the risk of cardiovascular events and death, early retirement and economic costs. Inpatient admissions and work absence are major contributors to economic costs.
AB - Aims: We aimed to examine cardiovascular events (stroke and myocardial infarction [MI]), mortality, early retirement and economic costs over 5 years in people with chronic heart failure (CHF) and matched controls in Sweden. Methods and results: Individuals (aged ≥16 years) living in Sweden on 1 January 2012 were identified in an existing database. Individuals with CHF were propensity score matched to controls without CHF by birth year, sex and educational status. We analysed risks of stroke, MI, mortality and early retirement, and compared direct costs (inpatient care, outpatient care and drug costs) and indirect costs (work absence). After matching, there were 53 520 individuals in each cohort. In each cohort, mean age was 69.0 years (standard deviation 8.2), and 29.7% of individuals were women. People with CHF were significantly more likely than controls to experience stroke (hazard ratio 1.46 [95% confidence interval 1.38–1.56]) and MI (1.61 [1.51–1.71]). All-cause mortality was nearly three-fold higher (2.89 [2.80–2.98]) and the likelihood of early retirement was more than three-fold higher (3.69 [3.08–4.42]). Total mean annual costs per person were €9663 (standard error 38) for people with CHF, of which 53% were direct costs, and €2845 (standard error 19) for controls, of which 40% were direct costs. In people with CHF, inpatient costs comprised 78% of total annual mean direct costs over follow-up, outpatient costs contributed 15% and drug costs contributed 8%. In controls, the corresponding proportions were 71%, 18% and 11%. Conclusions: CHF has a considerable impact on the risk of cardiovascular events and death, early retirement and economic costs. Inpatient admissions and work absence are major contributors to economic costs.
KW - Absenteeism
KW - Burden of illness
KW - Chronic heart failure
KW - Direct costs
KW - Indirect costs
KW - Mortality
U2 - 10.1002/ehf2.14480
DO - 10.1002/ehf2.14480
M3 - Article
C2 - 37814495
AN - SCOPUS:85173976004
SN - 2055-5822
VL - 11
SP - 54
EP - 64
JO - ESC Heart Failure
JF - ESC Heart Failure
IS - 1
ER -