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Aims The objectives of this study were to describe annual trends in patients hospitalized for heart failure ( HF) and HF-associated mortality rates in France between 2000 and 2012. Methods and results Hospital discharge data were extracted from the French National Hospitalization Database ( PMSI). Mortality data were obtained from the French National Mortality Database. HF events constituting the underlying or associated cause of death were selected. Rates were age standardized using the 2010 European census population as the standard population. Time trends were tested using a Poisson regression model. In 2012, the overall age-standardized rate of patients hospitalized for HF was 246.2 per 100 000 inhabitants. The age-standardized rate of HF-associated mortality was 113.8 per 100 000 inhabitants in 2010. Hospitalized patient rates remained steady between 2002 and 2012, whereas mortality decreased by 3.3% annually from 2000 to 2010. Trends in hospitalized patients and mortality differed significantly between men and women, particularly among the 45- to 55- and 65- to 74-year-old age groups, with a smaller decrease observed in women. Conclusion Among men, a slight decrease in patients hospitalized for HF and a substantial reduction in mortality were observed. Among women, only a large decrease in HF mortality was observed. HF remains one of the leading causes of death and hospitalization in France, particularly in the elderly. [ABSTRACT FROM AUTHOR]

Background The lessons learned from the study of maternal deaths depend on the accuracy of data. Our objective was to assess time trends in the underestimation of maternal mortality ( MM) in the national routine death statistics in France and to evaluate their current accuracy for the selection and causes of maternal deaths. Methods National data obtained by enhanced methods in 1989, 1999, and 2007-09 were used as the gold standard to assess time trends in the underestimation of MM ratios ( MMRs) in death statistics. Enhanced data and death statistics for 2007-09 were further compared by characterising false negatives ( FNs) and false positives ( FPs). The distribution of cause-specific MMRs, as assessed by each system, was described. Results Underestimation of MM in death statistics decreased from 55.6% in 1989 to 11.4% in 2007-09 ( P < 0.001). In 2007-09, of 787 pregnancy-associated deaths, 254 were classified as maternal by the enhanced system and 211 by the death statistics; 34% of maternal deaths in the enhanced system were FNs in the death statistics, and 20% of maternal deaths in the death statistics were FPs. The hierarchy of causes of MM differed between the two systems. The discordances were mainly explained by the lack of precision in the drafting of death certificates by clinicians. Conclusion Although the underestimation of MM in routine death statistics has decreased substantially over time, one third of maternal deaths remain unidentified, and the main causes of death are incorrectly identified in these data. Defining relevant priorities in maternal health requires the use of enhanced methods for MM study. [ABSTRACT FROM AUTHOR]