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Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care

Samskog, Viktor ; Davidge, Jason LU ; Halling, Anders LU and Agvall, Björn LU orcid (2023) In Scandinavian Journal of Primary Health Care
Abstract

Objective: This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings. Design: We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents. Subjects: From 2013–2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year. Main outcome measures: Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis. Results: In this Swedish... (More)

Objective: This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings. Design: We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents. Subjects: From 2013–2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year. Main outcome measures: Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis. Results: In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, p < 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter. Conclusion: In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
diagnostics, Heart failure, one-year mortality, primary care
in
Scandinavian Journal of Primary Health Care
publisher
Taylor & Francis
external identifiers
  • pmid:37994859
  • scopus:85177594106
ISSN
0281-3432
DOI
10.1080/02813432.2023.2283186
language
English
LU publication?
yes
id
dc0a52f2-1c9d-4198-9991-7229a1b44b6a
date added to LUP
2024-01-08 13:30:26
date last changed
2024-04-23 09:07:16
@article{dc0a52f2-1c9d-4198-9991-7229a1b44b6a,
  abstract     = {{<p>Objective: This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings. Design: We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents. Subjects: From 2013–2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year. Main outcome measures: Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis. Results: In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, p &lt; 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter. Conclusion: In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.</p>}},
  author       = {{Samskog, Viktor and Davidge, Jason and Halling, Anders and Agvall, Björn}},
  issn         = {{0281-3432}},
  keywords     = {{diagnostics; Heart failure; one-year mortality; primary care}},
  language     = {{eng}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Primary Health Care}},
  title        = {{Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care}},
  url          = {{http://dx.doi.org/10.1080/02813432.2023.2283186}},
  doi          = {{10.1080/02813432.2023.2283186}},
  year         = {{2023}},
}