Clinical, economical, and organizational Impact of chronic ischemic cardiovascular disease in Italy. Evaluation of 2019 nationwide hospital admissions data

Background: Chronic ischemic cardiovascular disease (CICD) is a common cardiovascular disease and a frequent cause of hospitalization, with significant differences between men and women. It is also an important comorbidity, affecting hospitalization length and mortality. The purpose of this paper is to investigate the clinical and economic impact of CICD on hospital admissions of non-surgical patients. Methods: To conduct the study, hospital discharge data (SDO) from each public and private hospital facility regularly sent by the regions to the Ministry of Health were analyzed, focusing on internal medicine, cardiology, and geriatrics departments’ 2019 discharged data coming from all Italian hospitals. Data were stratified according to age, gender, hospital charge ward, and costs. Results: The typical CICD patient is elderly (average age 80 years) and stays longer (+10.5 days) compared to the average one. They are also typically chronic patients with many comorbidities (respiratory and renal failure, as well as atrial fibrillation) in geriatrics and internal medicine departments, while in the cardiology departments, atrial fibrillation and outcomes of acute cardiovascular events predominate. Conclusions: CICD is a condition that leads to more hospitalizations in internal medicine departments than in cardiology and geriatrics departments and generates an average hospitalization value in line with the average one in internal medicine and geriatrics departments. In cardiology, the average value level is higher than the department average. Gender differences were found in cardiology departments; this data could suggest that the existing guidelines are affected by studies carried out mainly on males which lead to fewer recommendations for interventional procedures on females.