Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care
(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.
(Less)
- author
- Samskog, Viktor ; Davidge, Jason LU ; Halling, Anders LU and Agvall, Björn LU
- organization
- publishing date
- 2023
- 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 < 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}}, }