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Heart failure labelled patients with missing ejection fraction in primary care : prognosis and determinants
Muñoz, Miguel-Angel (Universitat Autònoma de Barcelona. Departament de Medicina)
Mundet Tudurí, Xavier (Universitat Autònoma de Barcelona)
Real, Jordi (Universitat Internacional de Catalunya. Epidemiologia i Salut Pública)
Del Val, José-Luis (Institut Català de la Salut)
Domingo, Mar (Institut Català de la Salut)
Vinyoles, Ernest (Universitat Autònoma de Barcelona. Departament de Medicina)
Calero, Ester (Institut Català de la Salut)
Checa, Caterina (EAP Dreta de l'Eixample (Barcelona))
Soldevila-Bacardit, Nuria (Institut Català de la Salut)
Verdú-Rotellar, José María (Universitat Autònoma de Barcelona. Departament de Medicina)

Date: 2017
Abstract: It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it registered, and (ii) the causes contributing to the differences in the availability of EF in EMR. Retrospective cohort analyses based on clinical records of HF and attended at 52 primary healthcare centres of Barcelona (Spain). Information of 8376 HF patients aged > 40 years followed during five years was analyzed. EF was available only in 8. 5% of primary care medical records. Cumulate incidence for mortality and hospitalization from 1st January 2009 to 31th December 2012 was 37. 6%. The highest rate was found in patients with missing EF (HR 1. 84, 95% CI 1. 68 -1. 95) compared to those with preserved EF. Patients hospitalized the previous year and those requiring home healthcare (HR 1. 81, 95% Confidence Interval 1. 68-1. 95 and HR 1. 58, 95% CI 1. 46-1. 71, respectively) presented a higher risk of having an adverse outcome. Older patients, those more socio-economically disadvantaged, obese, requiring home healthcare, and taking loop diuretics were less likely to have an EF registered. EF is poorly recorded in primary care. HF patients with EF missing at medical records had the worst prognosis. They tended to be older, socio-economically disadvantaged, and more fragile.
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Language: Anglès.
Document: article ; recerca ; publishedVersion
Subject: Primary care ; Heart failure ; Echocardiography ; Diagnosis
Published in: BMC Family Practice, Vol. 18 (March 2017) , art. 38, ISSN 1471-2296

PMID: 28302060
DOI: 10.1186/s12875-017-0612-6


Published Version
7 p, 440.6 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles

 Record created 2018-02-08, last modified 2019-02-15



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