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Is the diagnostic coding position of acute heart failure related to mortality? A report from the Euro Heart Failure Survey-1.

Abstract：

AIMS:Most studies on acute heart failure (HF) exploring the relationship between admissions to hospital for HF and subsequent outcomes have focused only on HF coded as the primary diagnosis, but many other patients have admissions complicated by HF requiring attention. Failure to quantify the total hospital burden of HF underestimates its health economic impact, leading to underprovision of resources for its care. METHODS AND RESULTS:The First Euro Heart Failure Survey (EHFS-1) screened consecutive deaths and discharges, regardless of cause, from medical wards in 115 hospitals from 24 European countries during 2000-2001, to identify patients with known or suspected HF. Information on presenting symptoms and signs were gathered. Of 10 701 patients enrolled, HF was reported as the primary reason for admission in 4234 (40%), a secondary reason for admission if it complicated or prolonged stay in 1772 (17%), and in 4695 (43%) patients it was uncertain whether HF was actively contributing to the admission. Mortality on the index admission was 301 (7%), 290 (16%), and 189 (4%), respectively, with hazard ratios of 1.73 (P < 0.001) and 3.26 (P < 0.001) compared with the 'uncertain' group. In the 12 weeks following discharge, 287 (7%) patients with a primary, 117 (8%) with a secondary, and 238 (5%) with an incidental or uncertain diagnosis of HF died. CONCLUSION:Patients admitted to hospital with HF as a secondary rather than a primary diagnosis have a high mortality. More attention should be focused on patients with a secondary diagnosis of HF in terms of both care and research.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Shoaib A,Farag M,Nasir M,John J,Gupta S,Pellicori P,Antony R,Perveen R,Rigby A,Goode KM,Yassin A,Clark AL,Cleland JG

doi

10.1002/ejhf.505

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

556-63

issue

5

eissn

1388-9842

issn

1879-0844

journal_volume

18

pub_type

杂志文章

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