Related Experiment Video
Updated: May 29, 2026
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Comorbidities and mortality associated with hospitalized heart failure in Canada
Sulan Dai1, Peter Walsh, Andy Wielgosz
1Public Health Agency of Canada, Ottawa, Ontario, Canada. Sulan.Dai@phac-aspc.gc.ca
Insights
Heart failure (HF) significantly increases hospital mortality and length of stay, especially in seniors. This condition is linked to numerous comorbidities, burdening the Canadian healthcare system.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Heart failure (HF) is a primary cause of hospitalization and mortality.
- HF frequently co-occurs with other medical conditions, escalating healthcare costs.
- Understanding HF's impact on hospital outcomes and associated comorbidities is crucial.
Purpose of the Study:
- To describe in-hospital mortality rates for heart failure (HF).
- To identify comorbid conditions frequently associated with HF hospitalizations.
- To assess the impact of HF on hospital stay duration and healthcare burden in Canada.
Main Methods:
- Analysis of acute care hospital separations data from 2005-2006 across Canadian provinces (excluding Québec).
- Identification of hospitalizations with a primary diagnosis of heart failure (ICD-10-CA codes I50, I500, I501, I509).
- Examination of comorbid diagnoses, mortality rates, and hospital stay lengths for HF patients compared to the general hospitalized population.
Main Results:
- Heart failure (HF) was the primary diagnosis in 1.9% of hospitalizations (42,399 separations) and a comorbid diagnosis in 4.9% of all hospitalizations.
- Individuals hospitalized with HF experienced a nearly 3-fold higher 30-day in-hospital mortality rate and a doubled mean hospital stay.
- HF patients averaged 3.9 comorbidities, with chronic ischemic heart disease, atrial fibrillation, and diabetes being most common; this is 1.7 times higher than for all causes.
Conclusions:
- Heart failure (HF) is associated with substantial in-hospital mortality, particularly in the elderly population.
- The high prevalence of comorbidities in HF patients contributes to prolonged hospital stays and increased healthcare system burden.
- Effective management of HF and its associated conditions is essential to mitigate its impact on Canadian healthcare resources.
Background:
Heart failure (HF) is a leading morbid cause of hospitalization and death. HF is often accompanied by comorbid conditions, increasing the health care burden. This study describes hospital mortality and identifies comorbid conditions associated with HF.
Methods:
Acute care hospital separations in 2005-2006, with a diagnosis of HF I50, I500, I501, I509 (The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA]) were identified from all Canadian jurisdictions except Québec.
Results:
A total of 2,457,527 hospital separations among 1,812,923 individuals, identifying 8,212,869 diagnoses were reported. Among those, a total of 33,693 (1.9%) of all hospitalized individuals had a most responsible diagnosis of HF, accounting for 42,399 hospital separations. Further, HF was coded 77,049 times as a comorbid diagnosis, altogether occurring in 4.9% of all hospitalizations. The most common primary diagnoses associated with comorbid HF were acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), and pneumonia. Seniors had a much higher hospitalization rate due to HF. Hospitalized individuals with a primary diagnosis of HF had an almost 3-fold higher 30-day in-hospital mortality rate and nearly double the mean hospital stay than that for all causes. On average, hospitalizations with a primary diagnosis of HF had 3.9 comorbidities, most commonly chronic ischemic heart disease (IHD), atrial fibrillation and flutter, diabetes, renal failure, etc.; 1.7 times greater for HF than for all causes.
Conclusions:
HF has a high in-hospital mortality rate particularly among the elderly and is associated with many cardiac and noncardiac conditions. HF necessitates long hospital stays, which increases the burden on the health care system in Canada.
Related Concept Videos
01:26Heart Failure III: Clinical Manifestations
01:27Heart Failure I: Introduction
01:17Pathophysiology of Heart Failure
01:29Heart Failure II: Pathophysiology
01:30Heart Failure V: Medical Management
01:30Heart Failure IV: Classification and Diagnostic Evaluation