tetano
Editor, Senior Moderator
Arch Cardiol Mex. 2019;89(1):118-125. doi: 10.24875/ACME.M19000034. [h=1]Evaluation of the effect of hospitalization on mortality in patients with heart failure followed in primary care.[/h]
Prado-Galbarro FJ[SUP]1,[/SUP][SUP]2[/SUP], Gami?o-Arroyo AE[SUP]1,[/SUP][SUP]3[/SUP], S?nchez-Piedra C[SUP]4[/SUP], S?nchez-P?jaro A[SUP]2[/SUP], Sarr?a-Santamera A[SUP]1,[/SUP][SUP]5,[/SUP][SUP]6,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h] 1 Research Unit, National School of Public Health, Institute of Health Carlos III, Madrid, Spain. 2 Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico. 3 Infectology Unit, Hospital Infantil de M?xico Federico G?mez, Mexico City, Mexico. 4 Research Unit, Spanish Society of Rheumatology. Madrid, Spain. 5 Faculty of Medicine, University of Alcal?, Alcal? de Henares. Madrid, Spain. 6 Health Services Research on Chronic Patients Network. Madrid, Spain. 7 IMIENS, UNED. Madrid, Spain.
[h=3]Abstract[/h] in English, Spanish
[h=4]Background:[/h] Heart failure (HF) is a serious health-care problem. The aim of this study is to evaluate the effect of the first acute episode of decompensated HF that requires a hospitalization on the survival of newly diagnosed cases of HF with follow-up for 5 years in primary care (PC).
[h=4]Methods:[/h] This was a longitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records of PC. Incident cases of HF from 2006 to 2010 or until death were studied through a survival analysis with Kaplan-Meier and Cox proportional hazards multivariate regression, after applying the propensity score matching technique (PSM).
[h=4]Results:[/h] A total of 3061 new cases of HF were identified. The PSM analysis was performed with 529 couples, with a total of 1058 patients. 5-year survival was 65% in no hospitalized and 53% in hospitalized patients. Factors with an increased risk of mortality were having prescribed nitrates (heart rate
= 1.56; 1.08-2.24). Factors with protective effect were having received the annual influenza vaccine (HR = 0.04; 0.01-0.15) and having been indicated X-rays by PC physician (HR = 0.76; 0.67-0.88).
[h=4]Conclusions:[/h] The findings indicate that hospitalizations are associated with a significant increase in mortality in patients recently diagnosed with HF. It is important to reinforce the need for the prevention of acute decompensated HF and for strategies to improve post-discharge outcomes.
Copyright: ? 2019 Permanyer.
[h=4]KEYWORDS:[/h] Atenci?n primaria; Espa?a; Heart failure; Hospitalizaci?n1; Hospitalization; Insuficiencia cardiaca; Mortalidad; Mortality; Primary care; Propensity score; Spain
PMID: 31702737 DOI: 10.24875/ACME.M19000034
Prado-Galbarro FJ[SUP]1,[/SUP][SUP]2[/SUP], Gami?o-Arroyo AE[SUP]1,[/SUP][SUP]3[/SUP], S?nchez-Piedra C[SUP]4[/SUP], S?nchez-P?jaro A[SUP]2[/SUP], Sarr?a-Santamera A[SUP]1,[/SUP][SUP]5,[/SUP][SUP]6,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h] 1 Research Unit, National School of Public Health, Institute of Health Carlos III, Madrid, Spain. 2 Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico. 3 Infectology Unit, Hospital Infantil de M?xico Federico G?mez, Mexico City, Mexico. 4 Research Unit, Spanish Society of Rheumatology. Madrid, Spain. 5 Faculty of Medicine, University of Alcal?, Alcal? de Henares. Madrid, Spain. 6 Health Services Research on Chronic Patients Network. Madrid, Spain. 7 IMIENS, UNED. Madrid, Spain.
[h=3]Abstract[/h] in English, Spanish
[h=4]Background:[/h] Heart failure (HF) is a serious health-care problem. The aim of this study is to evaluate the effect of the first acute episode of decompensated HF that requires a hospitalization on the survival of newly diagnosed cases of HF with follow-up for 5 years in primary care (PC).
[h=4]Methods:[/h] This was a longitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records of PC. Incident cases of HF from 2006 to 2010 or until death were studied through a survival analysis with Kaplan-Meier and Cox proportional hazards multivariate regression, after applying the propensity score matching technique (PSM).
[h=4]Results:[/h] A total of 3061 new cases of HF were identified. The PSM analysis was performed with 529 couples, with a total of 1058 patients. 5-year survival was 65% in no hospitalized and 53% in hospitalized patients. Factors with an increased risk of mortality were having prescribed nitrates (heart rate
= 1.56; 1.08-2.24). Factors with protective effect were having received the annual influenza vaccine (HR = 0.04; 0.01-0.15) and having been indicated X-rays by PC physician (HR = 0.76; 0.67-0.88).
[h=4]Conclusions:[/h] The findings indicate that hospitalizations are associated with a significant increase in mortality in patients recently diagnosed with HF. It is important to reinforce the need for the prevention of acute decompensated HF and for strategies to improve post-discharge outcomes.
Copyright: ? 2019 Permanyer.
[h=4]KEYWORDS:[/h] Atenci?n primaria; Espa?a; Heart failure; Hospitalizaci?n1; Hospitalization; Insuficiencia cardiaca; Mortalidad; Mortality; Primary care; Propensity score; Spain
PMID: 31702737 DOI: 10.24875/ACME.M19000034