Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom
Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom
复制标题
DOI：
10.1016/j.ejheart.2004.10.017
复制
发表时间：
2005-03-16
影响因子：
18.2
通讯作者：
Poole-Wilson, PA
中科院分区：
文献类型：
--
作者：
de Giuli, F;Khaw, KT;Poole-Wilson, PA
背景资料：有几个大的人群为基础的研究心力衰竭的发病率和结果，其中心力衰竭（HF）的诊断已作出由全科医生（GP）在community.Methods：从全科医学研究数据库在英国，我们选择了一个人口686,884人45岁或以上。在1991年发生的HF病例被分类为明确的HE、可能的HF或未诊断为HE的利尿剂的首次处方。人群被随访3年死亡率。共有6478例患者确诊为HF（平均年龄77.2岁，55.5%为女性），14，050人可能有HF，6076人在没有明确或可能诊断为HE的情况下接受利尿剂治疗。1000人/年和可能的HF 20.2/1000人/年。因其他原因首次使用利尿剂的人数为8.7人/1000人/年。男性的HE发生率较高。明确HF的发生率随年龄增加而增加。生存曲线显示在诊断为HE后的前3个月内死亡率较高。与英国人群相比，明确HF患者的一年累积死亡概率男性高15.9倍，女性高14.7倍。全科医生对HF的诊断成功地识别了死亡风险高的患者，与心脏病专家根据定义的诊断标准确定的HE患者相当。HF在一般人群中很常见，随着年龄的增长而急剧增加，并且预后不良。(C)2004年欧洲心脏病学会。出版社：Elsevier B.V版权所有。
Background: There are few large population-based studies of the incidence and outcome of heart failure where the diagnosis of heart failure (HF) has been made by a General Practitioner (GP) in the community.Methods: From the General Practice Research Database in the UK, we selected a population of 686,884 people 45 years or older. Incident cases of HF in 1991 were classified definite HE, possible HF, or a first prescription of diuretics without a diagnosis of HE The population was followed for 3-year mortality.Results: A total of 6478 patients had definite HF (mean age 77.2 years, 55.5% women), 14,050 had possible HF and 6076 persons were prescribed diuretics without a definite or possible diagnosis of HE The overall incidence of definite HF was 9.3/1000 persons/year and of possible HF 20.2/1000 persons/year. Diuretics were prescribed for the first time for other reasons for 8.7 persons/1000/year. The incidence of HE was higher in men. The incidence of definite HF increased with age. Survival curves showed higher mortality rates in the first 3 months after the diagnosis of HE One-year cumulative probability of death for patients with definite HF was 15.9 times higher in men and 14.7 times higher in women in comparison with the UK population.Conclusion: The diagnosis of HF by a GP successfully identifies patients at high risk of death, comparable to patients with HE identified by cardiologists on the basis of defined diagnostic criteria. HF is common in the general population, increases sharply with age, and has a poor prognosis. (C) 2004 European Society of Cardiology. Published by Elsevier B.V All rights reserved.