This study is a population-based, patient-level analysis of heart failure in England over a 5-year period using a dataset created by linking HES and NICOR databases. Our analyses will look into the re-occurrence of hospitalisation after the initial diagnosis of heart failure, the influence of population factors on risk of re-hospitalisation, and the resultant cost implications in an NHS environment.

Data from the National Heart Failure Audit (NICOR) and Hospital Episodes Statistics (NHS Digital) will be linked, by NHS Digital, using fields that are recorded in both databases (for example, NHS number). We will receive de-anonymised data that has been pseudo-anonymised, allowing for patient-level analyses but without identifying individual patients.

Inclusion Criteria:

• patients >17 years old
• individual patient data appears on both HES and NICOR databases
• 4-character primary diagnosis codes I50.0-I50.9

Exclusion Criteria:

• patient requests withdrawal from analyses

Acute decompensated heart failure (ADHF) is a sudden worsening of the signs and symptoms of heart failure, which typically includes difficulty breathing (dyspnoea) and leg oedema. ADHF is a common and potentially serious cause of acute respiratory distress. Treatment of ADHF consists of reducing the excess fluid retention with diuretics along with improving heart function with pharmacological treatment. Although pharmacological treatments exist for heart failure patients with reduced ejection fraction (ACE inhibitors, beta-blockers), a substantial fraction of patients exhibit preserved ejection fraction where treatment consists solely of management of comorbidities and symptoms.