Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study

Taylor, C. J. et al | 2019|Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study | BMJ | 364 |  doi: https://doi.org/10.1136/bmj.l223

A study that  looked at over 50,000 patients aged 45 and over with a new diagnosis of heart failure using data from the period 2000 to 2017 linking this with inpatient data and ONS mortality data. Over the course of the study’s duration there were 30 906 deaths in the heart failure group over the study period. Heart failure was listed on the death certificate in 13 093 as the primary cause of death. The study’s author conclude that after a diagnosis of heart failure has shown only modest improvement in the 21st century and lags behind other serious conditions, such as cancer. 

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Abstract

 

Objectives
To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group.

 

Design Population based cohort study.

 

Setting Primary care, United Kingdom.

 

Participants Primary care data for 55 959 patients aged 45 and over with a new diagnosis of heart failure and 278 679 age and sex matched controls in the Clinical Practice Research Datalink from 1 January 2000 to 31 December 2017 and linked to inpatient Hospital Episode Statistics and Office for National Statistics mortality data.


Main outcome measures
 Survival rates at one, five, and 10 years and cause of death for people with and without heart failure; and temporal trends in survival by year of diagnosis, hospital admission, and socioeconomic group.

Results Overall, one, five, and 10 year survival rates increased by 6.6%, and 6.4%, respectively. There were 30 906 deaths in the heart failure group over the study period. Heart failure was listed on the death certificate in 13 093 (42.4%) of these patients, and in 2237 (7.2%) it was the primary cause of death. Improvement in survival was greater for patients not requiring admission to hospital around the time of diagnosis. There was a deprivation gap in median survival of 2.4 years between people who were least deprived and those who were most deprived.

Conclusions Survival after a diagnosis of heart failure has shown only modest improvement in the 21st century and lags behind other serious conditions, such as cancer. New strategies to achieve timely diagnosis and treatment initiation in primary care for all socioeconomic groups should be a priority for future research and policy.

Read the full article in the BMJ Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study

See also:

Invest in GP services to improve heart failure survival

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