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Shoaib, Ahmad; Farag, Mohamed; Nasir, Mansoor; John, Joseph; Gupta, Sanjay; Pellicori, Pierpaolo; Antony, Renjith; Perveen, Rashida; Rigby, Alan; Goode, Kevin M.; Yassin, Ashraf; Clark, Andrew L.; Cleland, John G.F. (2016)
Publisher: Wiley
Languages: English
Types: Article
Subjects: R1
Aims: \ud \ud Most studies on acute heart failure (HF) exploring the relationship between admissions to hospital for HF and subsequent outcomes have focused only on HF coded as the primary diagnosis, but many other patients have admissions complicated by HF requiring attention. Failure to quantify the total hospital burden of HF underestimates its health economic impact, leading to underprovision of resources for its care.\ud Methods and results: \ud \ud The First Euro Heart Failure Survey (EHFS-1) screened consecutive deaths and discharges, regardless of cause, from medical wards in 115 hospitals from 24 European countries during 2000–2001, to identify patients with known or suspected HF. Information on presenting symptoms and signs were gathered. Of 10 701 patients enrolled, HF was reported as the primary reason for admission in 4234 (40%), a secondary reason for admission if it complicated or prolonged stay in 1772 (17%), and in 4695 (43%) patients it was uncertain whether HF was actively contributing to the admission. Mortality on the index admission was 301 (7%), 290 (16%), and 189 (4%), respectively, with hazard ratios of 1.73 (P < 0.001) and 3.26 (P < 0.001) compared with the ‘uncertain’ group. In the 12 weeks following discharge, 287 (7%) patients with a primary, 117 (8%) with a secondary, and 238 (5%) with an incidental or uncertain diagnosis of HF died.\ud Conclusion: \ud \ud Patients admitted to hospital with HF as a secondary rather than a primary diagnosis have a high mortality. More attention should be focused on patients with a secondary diagnosis of HF in terms of both care and research.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Cleland J, Dargie H, Hardman S, Mcdonagh T, Mitchell P. National Heart Failure Audit April2012-March 20132013. Available from: http://www.ucl.ac.uk/nicor/audits/heartfailure/additionalfiles/pdfs/annualreports/NHFA13 medium.pdf.
    • 2. Mehra MR, Butler J. Comorbid conditions in heart failure: an unhappy marriage. Heart Fail Clin. 2014 Apr;10(2):ix.
    • 3. McDonagh T, Cleland J, Dargie HJ, Whittaker T, Standing M, Mitchell M, Cunningham D. Ntional Heart Failure Audit April 2010-March 2011. National Institute For Cardiovascular Outcomes Research (NICOR), 2011 2012. Report No.
    • 4. Cleland JG, Swedberg K, Follath F, Komajda M, Cohen-Solal A, Aguilar JC, Dietz R, Gavazzi A, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, van Gilst WH, Widimsky J, Freemantle N, Eastaugh J, Mason J. The EuroHeart Failure survey programme-- a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J. 2003 Mar;24(5):442-63.
    • 5. Cleland JG, Khand A, Clark A. The heart failure epidemic: exactly how big is it? Eur Heart J. 2001 Apr;22(8):623-6.
    • 6. Adams KF, Jr., Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, Berkowitz RL, Galvao M, Horton DP. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005 Feb;149(2):209-16.
    • 7. Fonarow GC, Stough WG, Abraham WT, Albert NM, Gheorghiade M, Greenberg BH, O'Connor CM, Sun JL, Yancy CW, Young JB. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry. J Am Coll Cardiol. 2007 Aug 21;50(8):768-77.
    • 8. Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O'Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA. 2006 Nov 8;296(18):2217-26.
    • 9. Cleland J, Yassin A, Arrow Y, Taylor J, Britchford G, Goode K, Clark AL. Outcome of patients discharged on loop diuretic therapy with or without diagnosis of Heart Failure. Europeon Heart Failure 2009; Nice, France2009.
    • 10. Komajda M, Follath F, Swedberg K, Cleland J, Aguilar JC, Cohen-Solal A, Dietz R, Gavazzi A, Van Gilst WH, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, Widimsky J, Freemantle N, Eastaugh J, Mason J. The EuroHeart Failure Survey programme--a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur Heart J. 2003 Mar;24(5):464-74.
    • 11. Cleland JG, Swedberg K, Cohen-Solal A, Cosin-Aguilar J, Dietz R, Follath F, Gavazzi A, Hobbs R, Korewicki J, Madeira HC, Preda I, van Gilst WH, Widimsky J, Mareev V, Mason J, Freemantle N, Eastaugh J. The Euro Heart Failure Survey of the EUROHEART survey programme. A survey on the quality of care among patients with heart failure in Europe. The Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The Medicines Evaluation Group Centre for Health Economics University of York. Eur J Heart Fail. 2000 Jun;2(2):123-32.
    • 12. Cain KC, Lange NT. Approximate Case Influence for the Proportional Hazards Regression Model with Censored Data. Biometrics. 1984;40(2):493-9.
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