Association between process performance measures and 1-year mortality among patients with incident heart failure:a Danish nationwide study

Autor: Anne Nakano, Inge Schjødt, Nicklas Vinter, Marie Louise Svendsen, Søren Paaske Johnsen, Kenneth Egstrup
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Denmark
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
0302 clinical medicine
030212 general & internal medicine
Registries
Aged
80 and over
education.field_of_study
Process Assessment (Health Care)
Health Policy
Hazard ratio
Confounding
Process Assessment
Health Care
Middle Aged
Adrenergic beta-Antagonists/therapeutic use
Exercise Therapy
Heart Failure/diagnostic imaging
Angiotensin-Converting Enzyme Inhibitors/therapeutic use
Treatment Outcome
Echocardiography
Practice Guidelines as Topic
Female
Guideline Adherence
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Angiotensin II Type 1 Receptor Blockers/therapeutic use
Performance measures
Concordance
Population
Adrenergic beta-Antagonists
Heart failure
03 medical and health sciences
Patient Education as Topic
Internal medicine
medicine
Humans
Mortality
education
Aged
Heart Failure
Clinical registries
business.industry
Guideline
medicine.disease
Confidence interval
Denmark/epidemiology
business
Angiotensin II Type 1 Receptor Blockers
Patient education
Follow-Up Studies
Zdroj: Nakano, A, Vinter, N, Egstrup, K, Svendsen, M L, Schjødt, I & Johnsen, S P 2019, ' Association between process performance measures and 1-year mortality among patients with incident heart failure : a Danish nationwide study ', European heart journal. Quality of care & clinical outcomes, vol. 5, no. 1, pp. 28-34 . https://doi.org/10.1093/ehjqcco/qcy041
Nakano, A, Vinter, N, Egstrup, K, Svendsen, M L, Schjødt, I & Johnsen, S P 2019, ' Association between process performance measures and 1-year mortality among patients with incident heart failure : a Danish nationwide study ', European Heart Journal-Quality of Care and Clinical Outcomes, vol. 5, no. 1, pp. 28-34 . https://doi.org/10.1093/ehjqcco/qcy041
DOI: 10.1093/ehjqcco/qcy041
Popis: Aims: To examine the association between fulfilment of performance measures supported by clinical guidelines recommendations and 1-year mortality among patients with incident heart failure (HF) in Denmark.Methods and results: A nationwide population-based follow-up study based on the Danish Heart Failure Registry. All Danish hospital departments caring for patients with HF. We identified 24,308 in-and outpatients diagnosed with HF from 2003 to 2010. Quality of care was defined as receiving the guideline recommended processes of care: use of echocardiography, New-York-Heart-Association -classification, treatment with angiotensin-converting-enzyme inhibitors/angiotensin-II-receptor blocker, betablockers, physical training and patient education.Main outcome measure: 1-year mortality. We used multiple imputation and multivariable Cox Proportional Hazard Regression to compute Hazard Ratios (HRs) for 1-year mortality adjusted for potential confounding factors. Within 1 year, 17.1% of the patients died and the adjusted HRs ranged from 0.61 (95% Confidence Interval ((CI) 0.55-0.67)) for patient education to 0.99 (95% CI 0.90-1.10) for betablocker therapy. The association between meeting more performance measures and 1-year mortality appeared to follow a dose-response pattern: Using 0-25% of fulfilled measures as reference, patients who fulfilled 76- 100% of the performance measures had an adjusted HR of 0.43 (95% CI 0.38-0.48), while the adjusted HR was 0.96 (95% CI 0.86-1.07) for patients who fulfilled between 26-50% of the performance measures.Conclusion: Meeting process performance measures, which reflect care in concordance with clinical guideline recommendations, was associated with substantially lower 1-year mortality among patients with incident HF.
Databáze: OpenAIRE
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