Importance of diagnostic setting in determining mortality in patients with new-onset heart failure:temporal trends in Denmark from 1997 to 2017
Autor: | Deewa Zahir, Lars Køber, Morten Schou, John J.V. McMurray, Emil L. Fosbøl, Morten Lamberts, Saaima Parveen, Jawad H. Butt, Christian Madelaire, Anders Holt, Charlotte Andersson, Gunnar Gislason, Anojhaan Arulmurugananthavadivel, Mark C. Petrie, Christian Torp-Pedersen |
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Jazyk: | angličtina |
Rok vydání: | 2022 |
Předmět: |
Pediatrics
medicine.medical_specialty Denmark Competing risks New onset Medicine Humans In patient Heart Failure Inpatients business.industry Health Policy Mortality rate Incidence (epidemiology) Incidence Outpatient medicine.disease Prognosis Denmark/epidemiology Hospitalization Heart failure Risk of death Temporal trend Inpatient Cardiology and Cardiovascular Medicine business Lower mortality |
Zdroj: | Arulmurugananthavadivel, A, Holt, A, Parveen, S, Lamberts, M, Gislason, G H, Torp-Pedersen, C, Madelaire, C, Andersson, C, Zahir, D, Butt, J H, Petrie, M C, McMurray, J, Fosbol, E L, Kober, L & Schou, M 2022, ' Importance of diagnostic setting in determining mortality in patients with new-onset heart failure : temporal trends in Denmark from 1997 to 2017 ', European heart journal. Quality of care & clinical outcomes, vol. 8, no. 7, qcab073, pp. 750–760 . https://doi.org/10.1093/ehjqcco/qcab073 Arulmurugananthavadivel, A, Holt, A, Parveen, S, Lamberts, M, Gislason, G H, Torp-Pedersen, C, Madelaire, C, Andersson, C, Zahir, D, Butt, J H, Petrie, M C, McMurray, J, Fosbol, E L, Kober, L & Schou, M 2022, ' Importance of diagnostic setting in determining mortality in patients with new-onset heart failure : temporal trends in Denmark 1997-2017 ', European heart journal. Quality of care & clinical outcomes, vol. 8, no. 7, pp. 750-760 . https://doi.org/10.1093/ehjqcco/qcab073 |
Popis: | Aim To investigate temporal trends in inpatient vs. outpatient diagnosis of new-onset heart failure (HF) and the subsequent risk of death and hospitalization. Methods and results Using nationwide registers, 192 581 patients with a first diagnosis of HF (1997–2017) were included. We computed incidences of HF, age-standardized mortality rates, and absolute risks (ARs) of death and hospitalization (accounting for competing risk of death) to understand the importance of the diagnosis setting in relation to subsequent mortality and hospitalization. The overall incidence of HF was approximately the same (170/100 000 persons) every year during 1997–2017. However, in 1997, 77% of all first diagnoses of HF were made during a hospitalization, whereas the proportion was 39% in 2017. As inpatient diagnoses decreased, outpatient diagnoses increased from 23% to 61%. Outpatients had lower mortality and hospitalization rates than inpatients throughout the study period, although the 1-year age-standardized mortality rate decreased for each inpatient (24 to 14/100-person) and outpatient (11 to 7/100-person). One-year and five-year AR of death decreased by 11.1% and 17.0%, respectively, for all HF patients, while the risk of hospitalization for HF did not decrease significantly (1.13% and 0.96%, respectively). Conclusion Between 1997 and 2017, HF changed from being primarily diagnosed during hospitalization to being mostly diagnosed in the outpatient setting. Outpatients had much lower mortality rates than inpatients throughout the study period. Despite a significant decrease in mortality risk for all HF patients, neither inpatients nor outpatients experienced a reduction in the risk of an HF hospitalization. |
Databáze: | OpenAIRE |
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