Recurrent heart failure hospitalizations are associated with increased cardiovascular mortality in patients with heart failure in Clinical Practice Research Datalink
Autor: | Clare Proudfoot, Martin McSharry, Raquel Lahoz, Rachel Studer, S Corda, Ailís Fagan |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Heart failure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Original Research Articles Internal medicine Atrial Fibrillation medicine Humans In patient Original Research Article 030212 general & internal medicine Cardiovascular mortality Aged 80 and over business.industry Proportional hazards model Mortality rate Hazard ratio Mortality/survival Atrial fibrillation medicine.disease Hospitalization Clinical Practice lcsh:RC666-701 Hypertension Female Morbidity Cardiology and Cardiovascular Medicine business |
Zdroj: | ESC Heart Failure, Vol 7, Iss 4, Pp 1688-1699 (2020) ESC Heart Failure |
ISSN: | 2055-5822 |
Popis: | Aims Heart failure (HF) is a leading cause of hospitalization and is associated with high morbidity and mortality post‐diagnosis. Here, we examined the impact of recurrent HF hospitalization (HFH) on cardiovascular (CV) and all‐cause mortality among HF patients. Methods and Results Adult HF patients identified in the Clinical Practice Research Datalink with a first (index) hospitalization due to HF recorded in the Hospital Episode Statistics data set from January 2010 to December 2014 were included. Patients were followed up until death or end of study (December 2017). CV mortality as primary and as any reported cause and all‐cause mortality were evaluated. An extended Cox regression model was used for reporting adjusted relative CV mortality rates for time‐dependent recurrent HFHs. Overall, 8603 HF patients with an index hospitalization were included, providing 15 964 patient‐years of follow‐up. Patients were relatively old (median age: 80 years) and were mostly male (54.6%), with main co‐morbidities being hypertension and atrial fibrillation. Recurrent HFHs occurred one, two, three, and more than four times in 1561 (18.2%), 518 (6.02%), 206 (2.4%), and 153 (1.8%) patients, respectively. The median time to mortality was 215 (38–664) days for 50.8% of patients who died for any cause during the study period and 139 (27–531) days for 31.3% who died with CV reasons as primary cause. Compared with those of patients without recurrent HFHs, the adjusted hazard ratios (95% CI) for CV mortality as primary cause were 2.65 (2.35–2.99), 3.69 (3.06–4.43), 5.82 (4.48–7.58), and 5.95 (4.40–8.05) for those with one, two, three, and more than four recurrent HFHs. Conclusions There is a strong association between recurrent HFH and CV mortality, with the risk increasing progressively with each recurrent HFH. |
Databáze: | OpenAIRE |
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