Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease

Rutten, Frans H.; Cramer, Maarten-Jan M.; Grobbee, Diederick E.; Sachs, A. P. E.; Kirkels, J. H.; Lammers, Jan‐Willem J.; Hoes, Arno W.

doi:10.1093/eurheartj/ehi291

Cited by 389 publications

(318 citation statements)

References 38 publications

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“…Furthermore, many countries have shown that diagnostic tests are not consistently conducted in all patients with suspected HF (38). Diagnosis of HF is challenging, and cases can be misclassified under other diseases because symptoms can be nonspecific to HF, particularly in the elderly (39).…”

Section: Discussionmentioning

confidence: 99%

Administrative data have high variation in validity for recording heart failure

Quach

Blais

Quan

2010

Canadian Journal of Cardiology

126

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H eart failure (HF) has been widely studied because of its high mortality and morbidity rates (1-4). Studies on HF have relied on multiple data sources such as surveys, disease registries, hospital charts and administrative data. Of these sources, administrative data have been increasingly used for health services utilization and outcome evaluation.Administrative data result from implementing health care delivery, enrolling members into health insurance plans and reimbursing health care providers for services (5). The types of administrative data depend on the health care system and the funding structure. For example, Canada has a nationally funded health care system that collects hospital discharge data at a national level, while insurance registry, physician services and emergency room visit information is collected at a provincial level. Although these data are not intended for research, they are widely used in surveillance and outcome studies. Therefore, the validity of the research results rely on the quality of the data. Data quality is critical for interpreting variation across studies from different geographical areas.The purpose of the present study was to systematically review the literature pertaining to the validity of administrative data for recording HF and apply the International Classification of Diseases (ICD) HF definitions to Canadian hospital discharge abstract data to explore the prevalence of HF across ICD code definitions. METHODSLiterature review Search strategy: Only English language articles that compared the validity of ICD codes in administrative databases (eg, physician claims data, hospital discharge) with a reference standard (eg, chart review, registry, survey, case notes) were included. The literature search focused on articles published from 1990 to 2008. To identify peerreviewed journal articles, both the Ovid MEDLINE database and EMBASE were searched. Because validation studies were not indexed consistently with standard MeSH terms, the following key search terms were used: 'admin data', 'administrative data', 'population surveillance', 'heart failure', 'congestive heart failure', 'hospital data', 'physician claims', 'claims', 'hospital discharge', 'validation' and 'registries'. Next, Boolean operators were used to join search terms within the database search engines to locate articles. The reference lists from these articles were scanned to identify any additional articles that met heAlth outcomes/public policy ©2010 Pulsus Group Inc. All rights reserved Twenty-one studies validated hospital discharge abstract data; three studies validated physician claims and two studies validated ambulatory care data. Eighteen studies reported sensitivity (range 29% to 89%). Specificity and negative predictive value were greater than 70% across 17 studies. Nineteen studies reported positive predictive values (range 12% to 100%). Ten studies reported kappa values (range 0.39 to 0.84).

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Section: Discussionmentioning

confidence: 99%

Administrative data have high variation in validity for recording heart failure

Quach

Blais

Quan

2010

Canadian Journal of Cardiology

126

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“…The prevalence of chronic heart failure (CHF) in patients with chronic obstructive pulmonary disease (COPD) is known to range from 20% to 32% [1][2][3][4][5][6][7]. This high prevalence of CHF in patients with COPD is not surprising, because COPD and CHF share smoking as a common risk factor, and, moreover, it is likely that low-grade systemic inflammation accelerates progression of coronary atherosclerosis, which ultimately results in ischemic cardiomyopathy [8].…”

Section: Introductionmentioning

confidence: 99%

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

Matera

Martuscelli

Cazzola

2010

Pulmonary Pharmacology & Therapeutics

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“…Furthermore, the twelve-week placebocontrolled study in moderate-to-severe COPD demonstrated no cardiovascular effects of FFIS treatment using standard ECG and Holter monitoring [Nelson et al 2007], and other controlled studies of low-dose LABA treatment for COPD have reached the same conclusion [Campbell et al 2007;Ogale et al 2006;Ferguson et al 2003]. Therefore, it is difficult to determine if the observed deaths were related to treatment or the underlying cardiovascular comorbidities often associated with COPD [Sin et al 2006;Rutten et al 2005;Shih et al 1988]. …”

Section: Discussionmentioning

confidence: 99%

Long-term safety of nebulized formoterol: Results of a twelve-month open-label clinical trial

Donohue

Hanania

Fogarty

et al. 2008

Ther Adv Respir Dis

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Formoterol fumarate is a long-acting β 2 -agonist that is an effective bronchodilator for the maintenance management of patients with chronic obstructive pulmonary disease. The safety profile of the newly developed nebulized formoterol was evaluated over a twelve-month period in an open-label, active-control study. After completing a twelve-week double-blind doubledummy period, 569 subjects with chronic obstructive pulmonary disease entered an open-label extension study and received twice-daily 20 µg formoterol fumarate inhalation solution for nebulization (FFIS) or 12 µg formoterol fumarate dry powder inhalation (FA) for 52 weeks. Most of the FFIS-treated subjects (86%) completed at least six months of open-label treatment with over 90% compliance, comparable to the FA group (88%). Results of safety monitoring for adverse events, laboratory values, and cardiac changes were similar between treatment groups. Three hundred forty (73%) of FFIS-treated subjects and 83 (78%) of FA-treated subjects experienced an adverse event over the course of the study, the majority of which were mild to moderate and considered unrelated to treatment. COPD exacerbation occurred in 15.8% of FFIS-treated and 17.9% of FA-treated subjects. Deaths, serious adverse events, and discontinuations for adverse events occurred in 1.3, 16.2, and 5.4% of the nebulized group versus 1.9, 17.9, and 7.5% of the inhaled group, respectively. There were no clinically important changes from baseline in laboratory tests, including serum potassium and glucose, or vital signs and no treatment-related increases in cardiac arrhythmias, heart rate, or QTc prolongation. We conclude that nebulized formoterol fumarate twice daily is well tolerated over long-term treatment in moderate-to-severe COPD subjects and has a similar safety profile to the DPI formulation.

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Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease

Cited by 389 publications

References 38 publications

Administrative data have high variation in validity for recording heart failure

Administrative data have high variation in validity for recording heart failure

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

Long-term safety of nebulized formoterol: Results of a twelve-month open-label clinical trial

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