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Archivos de cardiología de México
versión On-line ISSN 1665-1731versión impresa ISSN 1405-9940
Resumen
PRADO-GALBARRO, Francisco J. et al. Evaluation of the effect of hospitalization on mortality in patients with heart failure followed in primary care. Arch. Cardiol. Méx. [online]. 2019, vol.89, n.2, pp.130-137. Epub 09-Dic-2020. ISSN 1665-1731. https://doi.org/10.24875/acm.m19000022.
Background:
Heart failure (HF) is a serious health-care problem. The aim of this study is to evaluate the effect of the first acute episode of decompensated HF that requires a hospitalization on the survival of newly diagnosed cases of HF with follow-up for 5 years in primary care (PC).
Methods:
This was a longitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records of PC. Incident cases of HF from 2006 to 2010 or until death were studied through a survival analysis with KaplanMeier and Cox proportional hazards multivariate regression, after applying the propensity score matching technique (PSM).
Results:
A total of 3061 new cases of HF were identified. The PSM analysis was performed with 529 couples, with a total of 1058 patients. 5-year survival was 65% in no hospitalized and 53% in hospitalized patients. Factors with an increased risk of mortality were having prescribed nitrates (heart rate [HR] = 1.56; 1.08-2.24). Factors with protective effect were having received the annual influenza vaccine (HR = 0.04; 0.01-0.15) and having been indicated X-rays by PC physician (HR = 0.76; 0.67-0.88).
Conclusions:
The findings indicate that hospitalizations are associated with a significant increase in mortality in patients recently diagnosed with HF. It is important to reinforce the need for the prevention of acute decompensated HF and for strategies to improve post-discharge outcomes.
Palabras llave : Heart failure; Primary care; Hospitalization; Mortality; Propensity score; Spain.