ICD-10 code-based definition of heart failure in Saint Petersburg electronic health records: prevalence, health care utilization and outcomes

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Aim. To assess total, ageand sex-specific survival rate after discharge of patients with heart failure (HF) using real-world electronic health data.Material and methods. This retrospective analysis of data from the St. Petersburg Chronic Heart Failure Registry was performed. Hospitalizations of patients aged 18 years with a diagnosis code I50.x (International Classification of Diseases, 10th revision) were included in the period from January 1, 2019 to December 31, 2023. Cases with acute myocardial infarction, cerebrovascular accident, coronavirus disease 2019, hospitalization duration of >30 days, and death during the current hospitalization were not included.Results. The study included 73450 patients aged 18 to 99 years (mean age, 73±12 years; women, 59,1%). During a median follow-up of 388 days, 16212 (22,1%) patients died. The cumulative death probability within one and five years after discharge was 16,3% and 48,9%. At each time period, the rate was higher in men when stratified by age and as age increased.The mortality rate was 15,3 (95% confidence interval 15,1 to 15,6) per 100 patientyears. For all subgroups, the highest value was recorded in the first month after discharge (50,1 per 100 patient-years), reaching a maximum in the subgroup of elderly and senile patients (60,7 per 100 patient-years).Conclusion. Within 1 year and 5 years after hospital discharge, 16,3% and 48,9% of patients with HF die, respectively. The highest death risk is typical in the first month after discharge, especially for elderly and senile patients.

Section: ключевые моменты Key Messagesunclassified

Total, ageand sex-specific mortality after discharge of patients with heart failure: the first large-scale cohort real-world study on Russian population

Soloveva,

Medvedev,

Lubkovsky

et al. 2024

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“…В. А. Алмазова" Минздрава России в рамках федерального проекта "Развитие сети национальных медицинских исследовательских центров и внедрение инновационных медицинских технологий". Структура запроса включала количество пациентов и случаев оказания медицинской помощи в 2019г, когда в диагнозе использовался хотя бы один из кодов МКБ-10: I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5, I42.6, I42.7, I42.8, I42.9, I43.0, I43.1, I43.2, I43.8, I50.х (расширенное кодирование) [9]. Пациентов с наличием хотя бы одного из данных кодов рассматривали как пациентов с СН.…”

Section: материал и методыunclassified

Analysis of the information about the incidence of heart failure, associated mortality and burden on the healthcare system, based on the encoding data in 15 subjects of the Russian Federation

Zvartau,

Solovyova,

Endubaeva

et al. 2023

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Aim. This study aims to assess the incidence of heart failure (HF) and associated mortality, and also the burden on the healthcare system in the subjects of Russian Federation, based on the HF encoding data.Material and methods. We made a structured request for the number of patients with HF and the number of cases of providing medical care in 2019. HF was understood to mean the presence of at least one of the codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5, I42.6, I42.7, I42.8, I42.9, I43.0, I43.1, I43.2, I43.8, I50.X (expanded encoding) according to International Classification of Diseases 10th Revision. The code I50.X was considered separately (the standard HF enconding).Results. The information about the incidence of HF, associated mortality and burden on the healthcare system was obtained from 15 subjects (53,6% from those that gave the data according to the request; the adult population is 18,9% from total adult population of Russian Federation). We noted significant heterogeneity between the regions. The median of the incidence of HF and associated mortality was 2,6 and 3,2% in accordance with the data of the expanded encoding, and 0,21 and 11,3% — according to the standard HF encoding. The presence of the code I50.x was observed in average in 9,4% of all cases of HF and defined the patients who frequently used emergency medical services and were frequently hospitalized (60 (18, 96) and 48 (20, 137) cases per 100 patients versus 9 (5, 24) and 17 (10, 70) cases in the expanded encoding).Conclusion. According to the encoding, the indicators of the incidence of HF and associated mortality vary greatly between the regions, the median values are 2,6 and 3,2% in expanded and 0,21 and 11,3% in standard approaches. In the standard encoding, there were more frequent use of emergency medical services and less number of outpatient visits. The development and introduction of a unified approach to encoding and recording the cases of HF will provide obtaining objective statistical data and using them for management decisions.

“…Сердечная недостаточность (СН) -одна из самых частых причин госпитализации в Российской Федерации (РФ) и мире [1,2]. Пациенты, госпитализированные с декомпенсацией СН, характеризуются высоким риском внутрибольничной летальности (3,8%), а в случае успешной стабилизации состояния в стационаре -риском повторной госпитализации с ухудшением СН и смерти (18,0 и 7,0% в течение 30 дней, 46,0 и 24,0% в течение 1 года) [3,4].…”

Section: рукопись полученаunclassified

“…по 01.10.2020. Критерием ХСН считали наличие кода I50.x в диагнозе с учетом его высокой специфичности в ранее выполненных валидационных исследованиях [2]. Медицинские данные оценивались в объеме деперсонифицированных выписных и посмертных эпикризов.…”

Section: материал и методыunclassified

Compliance of the management of hospitalized patients with heart failure with the quality criteria for health care: data from the St. Petersburg registry

Endubaeva,

Solovyova,

Medvedev

et al. 2023

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Aim. To assess the compliance of the management of patients with heart failure (HF) with quality criteria (QC) for health care, including discharge instructions for patients.Material and methods. Hospitalizations of patients aged over 18 years with HF (ICD 10 code — I50.x) during the period from January 1, 2019 to October 1, 2020 were randomly selected from the "Chronic Heart Failure" registry of St. Petersburg. Discharge and post-mortem summaries were assessed for compliance with the quality criteria listed in the 2020 Russian Chronic Heart Failure guidelines.Results. The study included 553 patients (women, 71,1%, mean age, 82,0±9 years, comorbidities: hypertension — 99,1%, coronary artery disease — 97,6%, chronic kidney disease — 53,2%, diabetes — 32,6%). Electrocardiography (QC № 1) was performed in 94,2% of patients, chest radiography (QC № 2) 91,7%, echocardiography (QC № 3) — 81,0%, but the results were not always informative. The exact ejection fraction (EF) value was reported in 55,4% of patients. Laboratory examination corresponded to QC № 4-6 in 20,3% of cases and was performed in 53,3-94,9%. Natriuretic peptides (NPs) were not determined (QC № 7-0%).The completeness of intravenous therapy (QC № 8) was not assessed due to insufficient physical examination data.Oral therapy (QC № 9) was prescribed frequently as follows: renin-angiotensinaldosterone system inhibitors (RAASo) — 93,3%, beta blockers (BBs) — 85,4%, mineralocorticoid receptor antagonists (MRAs) — 78,7%. However, triple RAAS+BB+MRA therapy was carried out in 54,1% of HF cases with EF <50% and no contraindications.Diet was recommended in 87,1% of summaries, water-salt regimen — 53,3%, drug titration — 8,2%. The date of visit to outpatient cardiologist was indicated in 10,0%.Conclusion. With the exception of NP assessment, the scope of paraclinical studies corresponded to the QC in the majority of patients. Optimal therapy was prescribed to 54,1% of patients with EF <50%. An early outpatient visit after discharge was indicated in 10,0% of summaries.