دورية أكاديمية
Frailty and co-morbidity predict first hospitalisation after heart failure diagnosis in primary care: population-based observational study in England.
| العنوان: | Frailty and co-morbidity predict first hospitalisation after heart failure diagnosis in primary care: population-based observational study in England. |
|---|---|
| المؤلفون: | Bottle A; Department of Primary Care and Public Health, Dr Foster Unit, Imperial College London, 3 Dorset Rise, London, UK.; Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, UK., Kim D; Department of Primary Care and Public Health, Dr Foster Unit, Imperial College London, 3 Dorset Rise, London, UK.; Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, UK., Hayhoe B; Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, UK., Majeed A; Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, UK., Aylin P; Department of Primary Care and Public Health, Dr Foster Unit, Imperial College London, 3 Dorset Rise, London, UK.; Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, UK., Clegg A; Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Bradford Royal Infirmary, Duckworth Lane, Bradford, UK., Cowie MR; National Heart & Lung Institute, Royal Brompton Hospital, Imperial College London, Sydney St, Chelsea, London, UK. |
| المصدر: | Age and ageing [Age Ageing] 2019 May 01; Vol. 48 (3), pp. 347-354. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0375655 Publication Model: Print Cited Medium: Internet ISSN: 1468-2834 (Electronic) Linking ISSN: 00020729 NLM ISO Abbreviation: Age Ageing Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: London, Baillière, Tindall. |
| مواضيع طبية MeSH: | Frail Elderly*, Heart Failure/*epidemiology , Hospitalization/*statistics & numerical data, Adult ; Age Factors ; Aged ; Aged, 80 and over ; Comorbidity ; Creatinine/blood ; Female ; Heart Failure/complications ; Heart Failure/diagnosis ; Humans ; Male ; Middle Aged ; Primary Health Care/statistics & numerical data ; Risk Factors ; Time Factors |
| مستخلص: | Background: frailty has only recently been recognised as important in patients with heart failure (HF), but little has been done to predict the first hospitalisation after diagnosis in unselected primary care populations. Objectives: to predict the first unplanned HF or all-cause admission after diagnosis, comparing the effects of co-morbidity and frailty, the latter measured by the recently validated electronic frailty index (eFI). Design: observational study. Setting: primary care in England. Subjects: all adult patients diagnosed with HF in primary care between 2010 and 2013. Methods: we used electronic health records of patients registered with primary care practices sending records to the Clinical Practice Research Datalink (CPRD) in England with linkage to national hospital admissions and death data. Competing-risk time-to-event analyses identified predictors of first unplanned hospitalisation for HF or for any condition after diagnosis. Results: of 6,360 patients, 9% had an emergency hospitalisation for their HF, and 39% had one for any cause within a year of diagnosis; 578 (9.1%) died within a year without having any emergency admission. The main predictors of HF admission were older age, elevated serum creatinine and not being on a beta-blocker. The main predictors of all-cause admission were age, co-morbidity, frailty, prior admission, not being on a beta-blocker, low haematocrit and living alone. Frailty effects were largest in patients aged under 85. Conclusions: this study suggests that frailty has predictive power beyond its co-morbidity components. HF patients in the community should be assessed for frailty, which should be reflected in future HF guidelines. (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: CPRD; emergency hospitalisation; frailty; heart failure; older people |
| المشرفين على المادة: | AYI8EX34EU (Creatinine) |
| تواريخ الأحداث: | Date Created: 20190110 Date Completed: 20200511 Latest Revision: 20200511 |
| رمز التحديث: | 20240513 |
| DOI: | 10.1093/ageing/afy194 |
| PMID: | 30624588 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1468-2834 |
|---|---|
| DOI: | 10.1093/ageing/afy194 |