COMMUNITY SURVEILLANCE OF CONGESTIVE HEART FAILURE

描述：(改编自《调查者摘要》)充血性心脏 心力衰竭(CHF)已被列为一种新出现的流行病，并呈上升趋势 在流行率和面临危险的人口规模方面。尽管如此， 充血性心力衰竭的流行病学知之甚少，有必要 以社区为基础的发病率、流行率、存活率、治疗和 证候的时间趋势。 在这一申请中，调查人员建议进行系统的 明尼阿波利斯-圣彼得堡35-84岁居民CHF监测 保罗大都会地区(人口245万，1995年估计) 互补领域：1)两个日历年因CHF住院， 相隔五年(1995年和2000年)；和2)新诊断的充血性心力衰竭 9年间(1993-2001)在大型健康维护机构中的成员 组织(HMO)。住院充血性心力衰竭的程度和特点 将在大都会地区的所有急性护理医院进行评估 (n=21)。将对具有ICD-9 CHF代码的所有放电的三分之一进行采样 随机(每个监测年度约5,000人)，由训练有素的人抽象 护士，并根据临床标准和结果进行分类 诊断性测试。新诊断的充血性心力衰竭将与复发区分开来 通过对医院记录的全面回顾，了解失代偿性充血性心力衰竭的发作情况。一个 对CHF的补充观点，包括门诊设置，将是 由HealthPartners成员的系统研究提供，HealthPartners是 明尼阿波利斯最大的医疗保健组织-圣彼得堡保罗。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充血性心力衰竭 (n约1900人)将被确认并确认诊断。起头 在1999年1月1日，新诊断的充血性心力衰竭病例将在 正在进行的基地(约600个)，通过邮寄调查，并跟踪一年 从最初的诊断来看。HealthPartners人群的监测 将补充医院监测，并将提供发病率数据， 流行率、治疗、资源使用和患者结果。 减轻美国慢性心力衰竭负担的努力将受益于 关于充血性心力衰竭流行病学的社区数据。调查人员指出 指出，拟议的监视结果将为 公共卫生决定，CHF更广泛的监测项目，以及 医疗工作成功与否的灵敏衡量标准。

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.