Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study
Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study
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DOI：
10.1016/j.ijcard.2017.05.080
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发表时间：
2017-09-15
影响因子：
3.5
通讯作者：
Corrao, Giovanni
中科院分区：
文献类型：
--
作者：
Baldi, Ileana;Azzolina, Danila;Corrao, Giovanni
背景资料：本研究旨在通过各种来源确定合并症，并评估其对心力衰竭（HF）患者队列相对生存率的短期影响。方法：从2008年至2010年意大利伦巴第大区的医院出院摘要（HDA）中确定新住院的HF患者。使用HDA评估Charlson合并症，并补充药物处方和疾病特异性豁免。一个考克斯模型是适合一年的相对生存从HF.Results：队列包括51,061 HF患者（53%的女性，中位年龄80岁）。综合各方面信息，糖尿病、慢性肺疾病和肾脏疾病的患病率分别为27.6%、26.2%和14.2%。合并症的患病率上升至78%。HF队列的生存率随着合并症数量的增加而变差，并且劣于参考人群。值得注意的是，相对生存模型的整体性能是相似的，无论使用的策略，以确定comorbidity.Conclusions：合并症群集在住院的HF患者，和增加合并症的负担与更差的生存。整合电子记录的综合检索以补充HDA可改善合并症的患病率估计，尽管它不能改善风险预测模型的区分。(C)2017爱思唯尔B. V.保留所有权利。
Background: This study aims to identify comorbidities through various sources and assess their short-termimpact on relative survival in a cohort of heart failure (HF) patients.Methods: Newly hospitalized HF patients were identified from hospital discharge abstracts (HDA) of Lombardy Region, Italy, from 2008 to 2010. Charlson comorbidities were assessed using the HDA and supplemented with drug prescriptions and disease-specific exemptions. A Cox model was fit for the one-year relative survival from HF.Results: The cohort consisted of 51,061 HF patients (53% women; median age 80 years). After integrating information from all sources, the prevalence rates of diabetes, chronic pulmonary disease and renal disease were 27.6%, 26.2% and 14.2%, respectively. The prevalence of comorbidity increased to 78%. Survival in the HF cohort was worse with increasing number of comorbidities and was inferior to that in the reference population. Notably, the overall performance of the relative survival models was similar regardless of the strategy used to ascertain comorbidity.Conclusions: Comorbidities cluster in hospitalized HF patients, and increasing comorbidity burden is associated with worse survival. Integration of a comprehensive search of electronic records to supplement HDA improves the prevalence estimates of comorbidities, although it does not improve discrimination of the risk prediction models. (C) 2017 Elsevier B.V. All rights reserved.