Clinical characteristics and mortality of patients with heart failure in Southern Sweden from 2013 to 2019 : a population-based cohort study
(2022) In BMJ Open 12(12). p.064997-064997- Abstract
OBJECTIVES: To describe clinical characteristics and prognosis related to heart failure (HF) phenotypes in a community-based population by applying a novel algorithm to obtain ejection fractions (EF) from electronic medical records. DESIGN: Retrospective population-based cohort study. SETTING: Data were collected for all patients with HF in Southwest Sweden. The region consists of three acute care hospitals, 40 inpatient wards, 2 emergency departments, 30 outpatient specialty clinics and 48 primary healthcare. PARTICIPANTS: 8902 patients had an HF diagnosis based on the International Classification of Diseases, Tenth Revision during the study period. Patients <18 years as well as patients declining to participate were excluded... (More)
OBJECTIVES: To describe clinical characteristics and prognosis related to heart failure (HF) phenotypes in a community-based population by applying a novel algorithm to obtain ejection fractions (EF) from electronic medical records. DESIGN: Retrospective population-based cohort study. SETTING: Data were collected for all patients with HF in Southwest Sweden. The region consists of three acute care hospitals, 40 inpatient wards, 2 emergency departments, 30 outpatient specialty clinics and 48 primary healthcare. PARTICIPANTS: 8902 patients had an HF diagnosis based on the International Classification of Diseases, Tenth Revision during the study period. Patients <18 years as well as patients declining to participate were excluded resulting in a study population of 8775 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was distribution of HF phenotypes by echocardiography. The secondary outcome measures were 1 year all-cause mortality and HR for all-cause mortality using Cox regression models. RESULTS: Out of 8775 patients with HF, 5023 (57%) had a conclusive echocardiography distributed into HF with reduced EF (35%), HF with mildly reduced EF (27%) and HF with preserved EF (38%). A total of 43% of the cohort did not have a conclusive echocardiography, and therefore no defined phenotype (HF-NDP). One-year all-cause mortality was 42% within the HF-NDP group and 30% among those with a conclusive EF. The HR of all-cause mortality in the HF-NDP group was 1.27 (95% CI 1.17 to 1.37) when compared with the confirmed EF group. There was no significant difference in survival within the HF phenotypes. CONCLUSIONS: This population-based study showed a distribution of HF phenotypes that varies from those in selected HF registries, with fewer patients with HF with reduced EF and more patients with HF with preserved EF. Furthermore, 1-year all-cause mortality was significantly higher among patients with HF who had not undergone a conclusive echocardiography at diagnosis, highlighting the importance of correct diagnostic procedure to improve treatment strategies and outcomes.
(Less)
- author
- Davidge, Jason LU ; Ashfaq, Awais ; Ødegaard, Kristina Malene ; Olsson, Mattias ; Costa-Scharplatz, Madlaina and Agvall, Björn
- organization
- publishing date
- 2022-12-16
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- echocardiography, epidemiology, heart failure
- in
- BMJ Open
- volume
- 12
- issue
- 12
- pages
- 064997 - 064997
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85144588945
- pmid:36526318
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2022-064997
- language
- English
- LU publication?
- yes
- id
- 1354fa25-4517-4189-98e6-0f81d3ddbcf2
- date added to LUP
- 2023-01-05 13:18:31
- date last changed
- 2024-06-13 22:52:31
@article{1354fa25-4517-4189-98e6-0f81d3ddbcf2,
abstract = {{<p>OBJECTIVES: To describe clinical characteristics and prognosis related to heart failure (HF) phenotypes in a community-based population by applying a novel algorithm to obtain ejection fractions (EF) from electronic medical records. DESIGN: Retrospective population-based cohort study. SETTING: Data were collected for all patients with HF in Southwest Sweden. The region consists of three acute care hospitals, 40 inpatient wards, 2 emergency departments, 30 outpatient specialty clinics and 48 primary healthcare. PARTICIPANTS: 8902 patients had an HF diagnosis based on the International Classification of Diseases, Tenth Revision during the study period. Patients <18 years as well as patients declining to participate were excluded resulting in a study population of 8775 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was distribution of HF phenotypes by echocardiography. The secondary outcome measures were 1 year all-cause mortality and HR for all-cause mortality using Cox regression models. RESULTS: Out of 8775 patients with HF, 5023 (57%) had a conclusive echocardiography distributed into HF with reduced EF (35%), HF with mildly reduced EF (27%) and HF with preserved EF (38%). A total of 43% of the cohort did not have a conclusive echocardiography, and therefore no defined phenotype (HF-NDP). One-year all-cause mortality was 42% within the HF-NDP group and 30% among those with a conclusive EF. The HR of all-cause mortality in the HF-NDP group was 1.27 (95% CI 1.17 to 1.37) when compared with the confirmed EF group. There was no significant difference in survival within the HF phenotypes. CONCLUSIONS: This population-based study showed a distribution of HF phenotypes that varies from those in selected HF registries, with fewer patients with HF with reduced EF and more patients with HF with preserved EF. Furthermore, 1-year all-cause mortality was significantly higher among patients with HF who had not undergone a conclusive echocardiography at diagnosis, highlighting the importance of correct diagnostic procedure to improve treatment strategies and outcomes.</p>}},
author = {{Davidge, Jason and Ashfaq, Awais and Ødegaard, Kristina Malene and Olsson, Mattias and Costa-Scharplatz, Madlaina and Agvall, Björn}},
issn = {{2044-6055}},
keywords = {{echocardiography; epidemiology; heart failure}},
language = {{eng}},
month = {{12}},
number = {{12}},
pages = {{064997--064997}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Open}},
title = {{Clinical characteristics and mortality of patients with heart failure in Southern Sweden from 2013 to 2019 : a population-based cohort study}},
url = {{http://dx.doi.org/10.1136/bmjopen-2022-064997}},
doi = {{10.1136/bmjopen-2022-064997}},
volume = {{12}},
year = {{2022}},
}