Is the diagnostic coding position of acute heart failure related to mortality? A report from the Euro Heart Failure Survey-1
Publication available at
Author(s)
Type
Journal Article
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.
Date Issued
2016-03-16
Online Publication Date
2016-03-16
2016-11-24T13:21:08Z
Date Acceptance
2016-01-26
ISSN
1879-0844
Publisher
Wiley
Start Page
556
End Page
563
Journal / Book Title
European Journal of Heart Failure
Volume
18
Issue
5
Copyright Statement
© 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology
Source Database
web-of-science
Sponsor
Royal Brompton & Harefield NHS Foundation Trust
National Institute for Health Research
Grant Number
N/A
N/A
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Acute heart failure
EHFS-1
Diagnostic position
Prognosis
QUALITY-OF-CARE
EJECTION FRACTION
SURVEY PROGRAM
OUTCOMES
REGISTRY
Cardiovascular System & Hematology
1102 Cardiovascular Medicine And Haematology
Publication Status
Published