Symptoms and signs in patients with heart failure : association with 3-month hospitalisation and mortality
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: To determine the association between symptoms and signs reported in primary care consultations following a new diagnosis of heart failure (HF), and 3-month hospitalisation and mortality.
DESIGN: Nested case-control study with density-based sampling.
SETTING: Clinical Practice Research Datalink, linked to hospitalisation and mortality (1998-2020).
PARTICIPANTS: Database cohort of 86 882 patients with a new HF diagnosis. In two separate analyses for (1) first hospitalisation and (2) death, we compared the 3-month history of symptoms and signs in cases (patients with HF with the event), with their respective controls (patients with HF without the respective event, matched on diagnosis date (±1 month) and follow-up time). Controls could be included more than once and later become a case.
MAIN OUTCOME MEASURES: All-cause, HF and non-cardiovascular disease (non-CVD) hospitalisation and mortality.
RESULTS: During a median follow-up of 3.22 years (IQR: 0.59-8.18), 56 677 (65%) experienced first hospitalisation and 48 146 (55%) died. These cases were matched to 356 714 and 316 810 HF controls, respectively. For HF hospitalisation, the strongest adjusted associations were for symptoms and signs of fluid overload: pulmonary oedema (adjusted OR 3.08; 95% CI 2.52, 3.64), shortness of breath (2.94; 2.77, 3.11) and peripheral oedema (2.16; 2.00, 2.32). Generic symptoms also showed significant associations: depression (1.50; 1.18, 1.82), anxiety (1.35; 1.06, 1.64) and pain (1.19; 1.10, 1.28). Non-CVD hospitalisation had the strongest associations with chest pain (2.93; 2.77, 3.09), fatigue (1.87; 1.73, 2.01), general pain (1.87; 1.81, 1.93) and depression (1.59; 1.44, 1.74).
CONCLUSIONS: In the primary care HF population, routinely recorded cardiac and non-specific symptoms showed differential risk associations with hospitalisation and mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:110 |
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| Enthalten in: |
Heart (British Cardiac Society) - 110(2024), 8 vom: 22. März, Seite 578-585 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ali, Mohammad Rizwan [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 25.03.2024 Date Revised 25.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/heartjnl-2023-323295 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM365314463 |
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| 100 | 1 | |a Ali, Mohammad Rizwan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Symptoms and signs in patients with heart failure |b association with 3-month hospitalisation and mortality |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 25.03.2024 | ||
| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVES: To determine the association between symptoms and signs reported in primary care consultations following a new diagnosis of heart failure (HF), and 3-month hospitalisation and mortality | ||
| 520 | |a DESIGN: Nested case-control study with density-based sampling | ||
| 520 | |a SETTING: Clinical Practice Research Datalink, linked to hospitalisation and mortality (1998-2020) | ||
| 520 | |a PARTICIPANTS: Database cohort of 86 882 patients with a new HF diagnosis. In two separate analyses for (1) first hospitalisation and (2) death, we compared the 3-month history of symptoms and signs in cases (patients with HF with the event), with their respective controls (patients with HF without the respective event, matched on diagnosis date (±1 month) and follow-up time). Controls could be included more than once and later become a case | ||
| 520 | |a MAIN OUTCOME MEASURES: All-cause, HF and non-cardiovascular disease (non-CVD) hospitalisation and mortality | ||
| 520 | |a RESULTS: During a median follow-up of 3.22 years (IQR: 0.59-8.18), 56 677 (65%) experienced first hospitalisation and 48 146 (55%) died. These cases were matched to 356 714 and 316 810 HF controls, respectively. For HF hospitalisation, the strongest adjusted associations were for symptoms and signs of fluid overload: pulmonary oedema (adjusted OR 3.08; 95% CI 2.52, 3.64), shortness of breath (2.94; 2.77, 3.11) and peripheral oedema (2.16; 2.00, 2.32). Generic symptoms also showed significant associations: depression (1.50; 1.18, 1.82), anxiety (1.35; 1.06, 1.64) and pain (1.19; 1.10, 1.28). Non-CVD hospitalisation had the strongest associations with chest pain (2.93; 2.77, 3.09), fatigue (1.87; 1.73, 2.01), general pain (1.87; 1.81, 1.93) and depression (1.59; 1.44, 1.74) | ||
| 520 | |a CONCLUSIONS: In the primary care HF population, routinely recorded cardiac and non-specific symptoms showed differential risk associations with hospitalisation and mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a heart failure | |
| 700 | 1 | |a Lam, Carolyn S P |e verfasserin |4 aut | |
| 700 | 1 | |a Strömberg, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Hand, Simon P P |e verfasserin |4 aut | |
| 700 | 1 | |a Booth, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Zaccardi, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Squire, Iain |e verfasserin |4 aut | |
| 700 | 1 | |a McCann, Gerry P |e verfasserin |4 aut | |
| 700 | 1 | |a Khunti, Kamlesh |e verfasserin |4 aut | |
| 700 | 1 | |a Lawson, Claire Alexandra |e verfasserin |4 aut | |
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