Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study
Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study
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DOI：
10.1136/bmj.l223
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发表时间：
2019-02-13
影响因子：
105.7
通讯作者：
Hobbs, F. D. Richard
中科院分区：
文献类型：
--
作者：
Taylor, Clare J.;Ordonez-Mena, Jose M.;Hobbs, F. D. Richard
目的：报告诊断为心力衰竭患者的短期和长期生存率的可靠估计，并评估诊断年份、住院情况和社会经济群体的趋势。设计基于人群的队列研究。初级保健，英国。参与者：在2000年1月1日至2017年12月31日的临床实践研究数据链中，55959名年龄在45岁及以上、新诊断为心力衰竭的患者和278 679名年龄和性别匹配的对照组的初级保健数据，并与住院患者住院事件统计数据和国家统计局死亡率数据相关联。主要结局指标：心力衰竭患者和非心力衰竭患者的1年、5年和10年生存率和死亡原因；以及按诊断年份、住院情况和社会经济群体划分的生存率的时间趋势。结果总体而言，1年、5年和10年生存率分别上升6.6%（从2000年的74.2%上升至2016年的80.8%）、7.2%（从2000年的41.0%上升至2012年的48.2%）和6.4%（从2000年的19.8%上升至2007年的26.2%）。在研究期间，心力衰竭组有30906人死亡。13 093例（42.4%）患者的死亡证明上列出了心力衰竭，2237例（7.2%）患者的主要死亡原因是心力衰竭。在诊断前后不需要住院的患者的生存改善更大(中位差为2.4年；5.3年vs 2.9年，P
OBJECTIVESTo report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.DESIGNPopulation based cohort study.SETTINGPrimary care, United Kingdom.PARTICIPANTSPrimary care data for 55 959 patients aged 45 and overwith a new diagnosis of heart failure and 278 679 age and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data.MAIN OUTCOME MEASURESSurvival rates at one, five, and 10 years and cause of death for people with and without heart failure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.RESULTSOverall, one, five, and 10 year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8% in 2016), 7.2% (from 41.0% in 2000 to 48.2% in 2012), and 6.4% (from 19.8% in 2000 to 26.2% in 2007), respectively. There were 30 906 deaths in the heart failure group over the study period. Heart failure was listed on the death certificate in 13 093 (42.4%) of these patients, and in 2237 (7.2%) it was the primary cause of death. Improvement in survival was greater for patients not requiring admission to hospital around the time of diagnosis (median difference 2.4 years; 5.3 v 2.9 years, P