Life expectancy for community-based patients with heart failure from time of diagnosis

James, Stephanie; Barton, David; O’Connell, Eoin; Voon, Victor; Murtagh, Gillian; Watson, Chris; Murphy, T; Prendiville, Brian; Brennan, David N.; Hensey, Mark; O’Neill, Louisa; O’Hanlon, Rory; Waterhouse, Deirdre; Ledwidge, Mark; Gallagher, Joe; McDonald, Ken

doi:10.1016/j.ijcard.2014.09.131

Cited by 19 publications

(21 citation statements)

References 20 publications

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“…Our mortality rates were similar to the 5-year mortality rate of 38% reported in a contemporary community cohort derived assembled in Ireland following a new diagnosis of HF. 24 Similarly, the ECHOES community based screening study, reported 5-year mortality rates of 38% for those with HF with preserved ejection fraction (HFPEF), and 47% with HF with reduced ejection fraction (HFREF) 25 although this was a cross sectional analysis and did not report on survival from time of diagnosis. Similarly data derived from Olmsted County reported a 5-year survival of 45%, but again was a cross-sectional survival analysis from the time of initiation of the study rather than the time of diagnosis of HF introducing bias towards worse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Mamas

Sperrin

Watson

et al. 2017

European J of Heart Fail

229

153

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Aims: To evaluate whether the survival rates of patients with heart failure (HF) in the community are better than those with a diagnosis of the 4 most common cancers in men and women in a contemporary primary care cohort in Scotland. Methods and Results:The data were obtained from the Primary Care Clinical Informatics Unit from a database of 1.75 million people registered with 393 general practices in Scotland. Sex-specific survival modeling was undertaken using Cox proportional hazards models, adjusted for potential confounders. A total of 56,658 patients were eligible to be included in the study with 147,938 person years follow up (median follow up 2.04 years). In men, heart failure (reference group; 5yrs survival 37.7%) had worse mortality outcomes than patients with prostate cancer (HR 0.61, 95%CI 0.57-0.65; 5yrs survival 49.0%), and bladder cancer (HR 0.88, 95%CI 0.81-0.96; 5yrs survival 36.5%), but better than lung cancer (HR 3.86, 95%CI 3.65-4.07; 5yrs survival 2.8%) and colorectal cancer (HR 1.23 95%CI 1.16-1.31; 5 yrs survival 25.9%). In women, patients with HF (reference group; 5yrs survival 31.9%) had worse mortality outcomes than patients with breast cancer (HR 0.55 95%CI 0.51-0.59; 5yrs survival 61.0%), but better outcomes than lung cancer (HR 3.82, 95%CI 3.60-4.05; 5yrs survival 3.6%), ovarian cancer (HR 1.98, 95%CI 1.80-2.17; 5yrs survival 19%) and colorectal cancer (HR 1.21, 95%CI 1.13-1.29; 5yrs survival 28.4%). Conclusions:Despite advances in management, heart failure remains as 'malignant' as some of the common cancers in both men and women.3

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Section: Discussionmentioning

confidence: 99%

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Mamas

Sperrin

Watson

et al. 2017

European J of Heart Fail

229

153

View full text Add to dashboard Cite

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“…The lack of clinical and lifestyle predictors, most likely justifies the low discrimination ability of the developed relative survival model [19]. Secondly, with improvements in treatment and decreases in hospital resources, more patients with HF are being managed in the community [20]. As a result, patients identified in this study through hospital discharges will probably be more representative of medically complex HF population.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study

Baldi

Azzolina

Berchialla

et al. 2017

International Journal of Cardiology

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of patients with heart failure"). Conflicts of Interest:The authors report no relationships that could be construed as a conflict of interest. 2 AbstractBackground. This study aims to identify comorbidities through various sources and to assess their short-term impact on relative survival in a cohort of Heart Failure (HF) patients. Methods.Newly hospitalized HF patients were identified from hospital discharge abstracts ( Results. The cohort consisted of 51,061 HF patients (53% women; median age 80 years). After integrating information from all sources, the prevalence of diabetes, chronic pulmonary disease and renal disease raised up to 27.6%, 26.2% and 14.2%, respectively.Survival in the HF cohort was inferior to that in the reference population and decreased with increasing number of comorbidities. Notably, the overall performance of the relative survival models was similar regardless of which strategy was used to ascertain comorbidity. Conclusions.The effort required to implement a comprehensive search method for comorbidities is worth the potential benefit when the aim is to assess the comorbidity burden. On the contrary, a search method limited to HDA can reasonably be used to determine a comorbidity profile for mortality risk adjustment purposes.

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“…The pooled survival rates at 1 month, and 1, 2, 5 and 10 years, respectively, were 95.7% (95% confidence interval 94.3-96.9), 86.5% (85.4-87.6), 72.6% (67.0-76.6), 56.7% (54.0-59.4) and 34.9% Only 19 studies reported data on cause of death, but in 14 of these a cardiovascular cause accounted for over 50% of the total deaths ( Table 2). 25,26,34,45,47,[50][51][52][53]56,60,61,63,64,67,69,[72][73][74]77 HF tended to be the most frequent cause of death but there was significant variation in the reported proportion of deaths related directly to HF, ranging from 8% to 64%.…”

Section: Summary Survival Rates and Causes Of Deathmentioning

confidence: 99%

Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis

Jones

Adoki

et al. 2019

European J of Heart Fail

329

244

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Aim To provide reliable survival estimates for people with chronic heart failure and explain variation in survival by key factors including age at diagnosis, left ventricular ejection fraction, decade of diagnosis, and study setting. Methods and results We searched in relevant databases from inception to August 2018 for non‐interventional studies reporting survival rates for patients with chronic or stable heart failure in any ambulatory setting. Across the 60 included studies, there was survival data for 1.5 million people with heart failure. In our random effects meta‐analyses the pooled survival rates at 1 month, 1, 2, 5 and 10 years were 95.7% (95% confidence interval 94.3–96.9), 86.5% (85.4–87.6), 72.6% (67.0–76.6), 56.7% (54.0–59.4) and 34.9% (24.0–46.8), respectively. The 5‐year survival rates improved between 1970–1979 and 2000–2009 across healthcare settings, from 29.1% (25.5–32.7) to 59.7% (54.7–64.6). Increasing age at diagnosis was significantly associated with a reduced survival time. Mortality was lowest in studies conducted in secondary care, where there were higher reported prescribing rates of key heart failure medications. There was significant heterogeneity among the included studies in terms of heart failure diagnostic criteria, participant co‐morbidities, and treatment rates. Conclusion These results can inform health policy and individual patient advanced care planning. Mortality associated with chronic heart failure remains high despite steady improvements in survival. There remains significant scope to improve prognosis through greater implementation of evidence‐based treatments. Further research exploring the barriers and facilitators to treatment is recommended.

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Life expectancy for community-based patients with heart failure from time of diagnosis

Cited by 19 publications

References 20 publications

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Comorbidity-adjusted relative survival in newly hospitalized heart failure patients: A population-based study

Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis

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