没有超声心动图的心力衰竭患者更常在医院诊断,与初级保健相比,死亡率更高。

IF 1.9 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Scandinavian Journal of Primary Health Care Pub Date : 2024-03-01 Epub Date: 2024-02-07 DOI:10.1080/02813432.2023.2283186
Viktor Samskog, Jason Davidge, Anders Halling, Björn Agvall
{"title":"没有超声心动图的心力衰竭患者更常在医院诊断,与初级保健相比,死亡率更高。","authors":"Viktor Samskog, Jason Davidge, Anders Halling, Björn Agvall","doi":"10.1080/02813432.2023.2283186","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings.</p><p><strong>Design: </strong>We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents.</p><p><strong>Subjects: </strong>From 2013-2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year.</p><p><strong>Main outcome measures: </strong>Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis.</p><p><strong>Results: </strong>In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, <i>p</i> < 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter.</p><p><strong>Conclusion: </strong>In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851830/pdf/","citationCount":"0","resultStr":"{\"title\":\"Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care.\",\"authors\":\"Viktor Samskog, Jason Davidge, Anders Halling, Björn Agvall\",\"doi\":\"10.1080/02813432.2023.2283186\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings.</p><p><strong>Design: </strong>We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents.</p><p><strong>Subjects: </strong>From 2013-2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year.</p><p><strong>Main outcome measures: </strong>Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis.</p><p><strong>Results: </strong>In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, <i>p</i> < 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter.</p><p><strong>Conclusion: </strong>In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.</p>\",\"PeriodicalId\":21521,\"journal\":{\"name\":\"Scandinavian Journal of Primary Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851830/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Journal of Primary Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02813432.2023.2283186\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Primary Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02813432.2023.2283186","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

目的:瑞典的这项研究旨在评估在医院和初级保健机构中未经超声心动图诊断的心力衰竭患者的患病率、相关临床因素和死亡率。设计:我们进行了一项基于人群的回顾性研究,使用来自瑞典哈兰地区医疗数据库的数据,涵盖了33万名居民。研究对象:2013-2019年,3903例未经超声心动图诊断为偶发性心力衰竭的患者接受了为期一年的随访。主要结局指标:使用logistic和Cox回归分析,我们评估了诊断后30、100和365天的患病率、临床特征和全因死亡率。结果:在这个瑞典队列中,在医院诊断的患者一年的全因死亡率(42%)明显高于在初级保健中诊断的患者(20%)。结论:在瑞典地区,没有超声心动图的心力衰竭诊断在医院更常见,这些患者最初面临更差的预后。然而,在第一个月之后,医院诊断的患者的预后与初级保健诊断的患者的预后一致。这些发现强调需要在护理环境中改进诊断和治疗方法,以提高结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care.

Objective: This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings.

Design: We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents.

Subjects: From 2013-2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year.

Main outcome measures: Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis.

Results: In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, p < 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter.

Conclusion: In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.20
自引率
19.00%
发文量
47
审稿时长
>12 weeks
期刊介绍: Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice. Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include: • Clinical family medicine • Epidemiological research • Qualitative research • Health services research.
期刊最新文献
Healthcare seeking - who, when and why? Diagnostic accuracy of signs and symptoms in acute coronary syndrome and acute myocardial infarction. Is general practitioner involvement in the initiation of opioids for chronic non-cancer pain associated with opioid dose and concurrent drug use? The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway. General practitioners’ knowledge and practice in consultations with (potential) torture victims: a qualitative pilot study from Norway
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1