Incident heart failure: comparing management and outcome in primary care and hospital settings in Western Sweden 2008-2017
Abstract Background Heart failure (HF) is a major problem in primary care (PC) and hospital care (HC). HF patients managed in these two settings may differ in their demography, comorbidities, treatment and outcomes. Aim We aimed to compare the patient management in PC and HC in the Västra Götaland R...
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| Veröffentlicht in: | European heart journal 2024-10, Vol.45 (Supplement_1) |
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| creator | Chen, X Pivodic, A Schaufelberger, M Fu, M |
| description | Abstract
Background
Heart failure (HF) is a major problem in primary care (PC) and hospital care (HC). HF patients managed in these two settings may differ in their demography, comorbidities, treatment and outcomes.
Aim
We aimed to compare the patient management in PC and HC in the Västra Götaland Region (VGR) in Sweden.
Methods
The VEGA database is an administrative database includes all patients living in VGR. Patients with a first principal or contributory diagnosis of HF (I50) ≥18 years old between 2008 and 2017 were included. One-year mortality was used as the outcome.
Results
In total, 62,229 new-onset HF cases were included, with 18,722 identified only in PC and 16,651 in HC. HF patients in PC were older (80.7±10.9 vs 76.1±13.6), more women (57.1% vs 44.9%), with more hypertension, musculoskeletal and mental disorders, but less myocardial infarction. Guideline directed medical therapy was more frequently used in HC despite similar medication before HF diagnosis. Patients in HC had almost 4 times higher all-cause 1-year mortality [3.92 (3.77 - 4.08), p |
| doi_str_mv | 10.1093/eurheartj/ehae666.899 |
| format | Article |
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Background
Heart failure (HF) is a major problem in primary care (PC) and hospital care (HC). HF patients managed in these two settings may differ in their demography, comorbidities, treatment and outcomes.
Aim
We aimed to compare the patient management in PC and HC in the Västra Götaland Region (VGR) in Sweden.
Methods
The VEGA database is an administrative database includes all patients living in VGR. Patients with a first principal or contributory diagnosis of HF (I50) ≥18 years old between 2008 and 2017 were included. One-year mortality was used as the outcome.
Results
In total, 62,229 new-onset HF cases were included, with 18,722 identified only in PC and 16,651 in HC. HF patients in PC were older (80.7±10.9 vs 76.1±13.6), more women (57.1% vs 44.9%), with more hypertension, musculoskeletal and mental disorders, but less myocardial infarction. Guideline directed medical therapy was more frequently used in HC despite similar medication before HF diagnosis. Patients in HC had almost 4 times higher all-cause 1-year mortality [3.92 (3.77 - 4.08), p<0.0001] compared with PC after adjustment for age and sex. Over 10-year period, despite decreasing mortality in both settings, hazard ratios for HC vs. PC were significantly increased for all patients (p for interaction 0.0004), which was more marked in female and for 70-80 years old patients.
Conclusion
Over a 10-year period, not withstanding decreasing mortality in HF patients in both PC and HC settings, differences remain between these two HF populations not only demographic profile and medications but also outcomes.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehae666.899</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>European heart journal, 2024-10, Vol.45 (Supplement_1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Chen, X</creatorcontrib><creatorcontrib>Pivodic, A</creatorcontrib><creatorcontrib>Schaufelberger, M</creatorcontrib><creatorcontrib>Fu, M</creatorcontrib><title>Incident heart failure: comparing management and outcome in primary care and hospital settings in Western Sweden 2008-2017</title><title>European heart journal</title><description>Abstract
Background
Heart failure (HF) is a major problem in primary care (PC) and hospital care (HC). HF patients managed in these two settings may differ in their demography, comorbidities, treatment and outcomes.
Aim
We aimed to compare the patient management in PC and HC in the Västra Götaland Region (VGR) in Sweden.
Methods
The VEGA database is an administrative database includes all patients living in VGR. Patients with a first principal or contributory diagnosis of HF (I50) ≥18 years old between 2008 and 2017 were included. One-year mortality was used as the outcome.
Results
In total, 62,229 new-onset HF cases were included, with 18,722 identified only in PC and 16,651 in HC. HF patients in PC were older (80.7±10.9 vs 76.1±13.6), more women (57.1% vs 44.9%), with more hypertension, musculoskeletal and mental disorders, but less myocardial infarction. Guideline directed medical therapy was more frequently used in HC despite similar medication before HF diagnosis. Patients in HC had almost 4 times higher all-cause 1-year mortality [3.92 (3.77 - 4.08), p<0.0001] compared with PC after adjustment for age and sex. Over 10-year period, despite decreasing mortality in both settings, hazard ratios for HC vs. PC were significantly increased for all patients (p for interaction 0.0004), which was more marked in female and for 70-80 years old patients.
Conclusion
Over a 10-year period, not withstanding decreasing mortality in HF patients in both PC and HC settings, differences remain between these two HF populations not only demographic profile and medications but also outcomes.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqNkEtLAzEUhYMoWKs_QcgfmDaPSWbiToqPQsGFBd0Nt5mbdkrnQZJB9Nc70xbXru7inO-cyyHknrMZZ0bOsfc7BB_3c9wBaq1nuTEXZMKVEInRqbokE8aNSrTOP6_JTQh7xliuuZ6Qn2VjqxKbSI8R1EF16D0-UNvWHfiq2dIaGthiPXqgKWnbx0FDWjW081UN_pta8HjUdm3oqggHGjDGgQ2j6wNDRN_Q9y8ciqgYqhPBeHZLrhwcAt6d75Ssn5_Wi9dk9fayXDyuEptnJhGp1FBak3LGBKYO0KI1IuNMCSylRJBCY84FgDLOlU5b3GykRaeycsOUnBJ1irW-DcGjK85vF5wV437F337Feb9i2G_g2Ilr--6fyC-CVHrz</recordid><startdate>20241028</startdate><enddate>20241028</enddate><creator>Chen, X</creator><creator>Pivodic, A</creator><creator>Schaufelberger, M</creator><creator>Fu, M</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20241028</creationdate><title>Incident heart failure: comparing management and outcome in primary care and hospital settings in Western Sweden 2008-2017</title><author>Chen, X ; Pivodic, A ; Schaufelberger, M ; Fu, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-2436adc941002e4faecec9271052ed33ea326e812aa59ffdf6cebb3cef57db053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, X</creatorcontrib><creatorcontrib>Pivodic, A</creatorcontrib><creatorcontrib>Schaufelberger, M</creatorcontrib><creatorcontrib>Fu, M</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, X</au><au>Pivodic, A</au><au>Schaufelberger, M</au><au>Fu, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incident heart failure: comparing management and outcome in primary care and hospital settings in Western Sweden 2008-2017</atitle><jtitle>European heart journal</jtitle><date>2024-10-28</date><risdate>2024</risdate><volume>45</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Heart failure (HF) is a major problem in primary care (PC) and hospital care (HC). HF patients managed in these two settings may differ in their demography, comorbidities, treatment and outcomes.
Aim
We aimed to compare the patient management in PC and HC in the Västra Götaland Region (VGR) in Sweden.
Methods
The VEGA database is an administrative database includes all patients living in VGR. Patients with a first principal or contributory diagnosis of HF (I50) ≥18 years old between 2008 and 2017 were included. One-year mortality was used as the outcome.
Results
In total, 62,229 new-onset HF cases were included, with 18,722 identified only in PC and 16,651 in HC. HF patients in PC were older (80.7±10.9 vs 76.1±13.6), more women (57.1% vs 44.9%), with more hypertension, musculoskeletal and mental disorders, but less myocardial infarction. Guideline directed medical therapy was more frequently used in HC despite similar medication before HF diagnosis. Patients in HC had almost 4 times higher all-cause 1-year mortality [3.92 (3.77 - 4.08), p<0.0001] compared with PC after adjustment for age and sex. Over 10-year period, despite decreasing mortality in both settings, hazard ratios for HC vs. PC were significantly increased for all patients (p for interaction 0.0004), which was more marked in female and for 70-80 years old patients.
Conclusion
Over a 10-year period, not withstanding decreasing mortality in HF patients in both PC and HC settings, differences remain between these two HF populations not only demographic profile and medications but also outcomes.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehae666.899</doi></addata></record> |
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| source | Oxford University Press Journals |
| title | Incident heart failure: comparing management and outcome in primary care and hospital settings in Western Sweden 2008-2017 |
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