COMMUNITY SURVEILLANCE OF CONGESTIVE HEART FAILURE

描述：（改编自研究者摘要）充血性心脏 失败（CHF）已被挑出来作为一种新兴的流行病， 患病率和患病人群的规模。 不过 CHF的流行病学知之甚少，需要 以社区为基础的研究的发病率，患病率，生存率，治疗， 综合征的时间趋势。 在本申请中，研究人员建议进行系统的 监测CHF的居民，35-84岁，明尼阿波利斯-圣。 保罗都市区（人口245万，1995年估计） 补充领域：1）两个日历年内因CHF住院， 相隔5年（1995年和2000年）;和2）新诊断的CHF超过 9-2001年期间（1993-2001年）， 卫生组织。 住院心力衰竭的程度和特点 将在大都会地区的所有急诊医院进行评估 （N=21）。 将对ICD-9 CHF代码的所有出院病例的三分之一进行采样 随机（每个监测年约5，000人），由训练有素的 护士，并根据临床标准和结果分类， 诊断测试 新诊断的CHF将与复发性CHF区分开来。 通过全面审查医院记录发现失代偿性CHF发作。 一 对CHF（包括门诊环境）的补充观点将是 提供了一个系统的研究健康伙伴的成员，其中一个 明尼阿波利斯-圣保罗最大的健康维护组织 使用HealthPartners数据库， 1993年1月1日至2001年12月31日期间所有新诊断的CHF病例 （约1，900人）将得到确认，诊断将得到验证。 开始 1999年1月1日，新诊断的CHF病例将在 正在进行的基地（n约600），通过邮件调查，并跟踪一年 从最初的诊断。 对HealthPartners人群的监测 将补充医院监测，并将提供发病率数据， 患病率、治疗、资源使用和患者结局。 减轻美国CHF负担的努力将受益于 以社区为基础的CHF流行病学数据。 调查人员指出， 建议的监测结果将为以下方面提供指导： 公共卫生决策，更广泛的CHF监测项目，以及 衡量医疗工作成功与否的敏感指标。

DESCRIPTION: (Adapted from Investigator's Abstract) Congestive Heart Failure (CHF) has been singled out as an emerging epidemic with an increase in prevalence and the size of the population at risk. Nonetheless, the epidemiology of CHF is poorly understood, and there is a need for community-based studies of the incidence, prevalence, survival, therapy, and time trends of the syndrome. In this application, the investigators propose to conduct systematic surveillance of CHF among residents, 35-84 years old, of the Minneapolis-St. Paul metropolitan area (population 2.45 million, 1995 estimate) in two complementary domains: 1) hospitalization for CHF in two calendar years, five years apart (1995 and the year 2000); and 2) newly diagnosed CHF over 9-year period (1993-2001) among members of a large Health Maintenance Organization (HMO). The magnitude and characteristics of hospitalized CHF will be assessed in all acute care hospitals of the metropolitan area (N=21). One-third of all discharges with ICD-9 CHF codes will be sampled randomly (n about 5,000 per surveillance year), abstracted by trained nurses, and classified according to clinical criteria and the results of diagnostic tests. Newly diagnosed CHF will be distinguished from recurrent episodes of decompensated CHF by thorough review of the hospital record. A complementary perspective on CHF, including the outpatient setting, will be provided by a systematic study of members of HealthPartners, one of the largest HMOs in Minneapolis-St. Paul. Using the HealthPartners database, all newly diagnosed CHF cases between January 1, 1993 and December 31, 2001 (n about 1,900) will be identified and the diagnosis validated. Beginning in January 1, 1999, newly diagnosed CHF cases will be identified on an ongoing bases (n about 600), surveyed by mail, and followed for one-year from the original diagnosis. Surveillance of the HealthPartners population will supplement hospital surveillance and will contribute data on incidence, prevalence, treatment, use of resources, and patient outcomes. Efforts to reduce the burden of CHF in the U.S. will benefit from community-based data on the epidemiology of CHF. The investigators point out that the results of the proposed surveillance will provide guidance to public health decisions, broader surveillance projects of CHF, and a sensitive gauge of the success of medical efforts.