| アブストラクト | BACKGROUND: We investigated symptoms reported before and after heart failure (HF) diagnosis and their associations with 3-month hospitalisation and mortality. OBJECTIVES: To examine associations between symptoms recorded in primary care and short-term hospitalisation and mortality in HF patients. DESIGN: Landmark analysis using Royston-Parmar survival models at baseline (diagnosis), 6 and 12 months post-diagnosis. SETTING: Primary care database (Clinical Practice Research Datalink) linked to hospital and mortality data (1998-2020). PARTICIPANTS: Adults (>40 years) with a first HF diagnosis. EXPOSURES: Shortness of breath, ankle swelling, oedema, fatigue, chest pain, depression and anxiety in the 3 months before diagnosis and at 6 and 12 months. OUTCOMES: 3-month all-cause hospitalisation and mortality; secondary outcomes included HF and non-cardiovascular hospitalisation. RESULTS: Among 86 882 HF patients (62 742 and 54 555 surviving to 6 and 12 months, respectively), the magnitude of symptom risk varied by timepoint. Specifically, the symptoms with the strongest associations with adverse outcomes were: depression for all-cause hospitalisation at diagnosis (HR: 1.26; 95% CI 1.15 to 1.39) and 6 months (1.46; 1.25 to 1.70); ankle swelling for mortality (1.49; 1.14 to 1.94) at 6 months and SOB for HF hospitalisation (1.18; 1.12 to 1.26) at diagnosis and 12 months (1.99; 1.68 to 2.35). CONCLUSIONS: Symptoms persisted and were more prominent at 6 and 12 months post-diagnosis than at diagnosis. |
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| 投稿者 | Ali, Mohammad Rizwan; Lam, Carolyn S P; Stromberg, Anna; Hand, Simon P P; Booth, Sarah; Zaccardi, Francesco; McCann, Gerry P; Khunti, Kamlesh; Lawson, Claire A |
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| 組織名 | Leicester Real World Evidence Unit, Department of Population and Health Sciences,;University of Leicester, Leicester, UK mra30@leicester.ac.uk.;Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.;NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital,;Leicester, UK.;Diabetes Research Centre, University of Leicester, Leicester, UK.;National Heart Centre Singapore, 5 Hospital Drive, National University Singapore;Faculty of Science, Singapore.;Duke-National University of Singapore Medical School, Singapore.;Department of Health, Medicine and Caring Sciences, Linkopings Universitet,;Linkoping, Sweden.;Department of Cardiology, Linkoping University, Linkoping, Sweden.;Department of Population Health Sciences, University of Leicester, Leicester, UK.;University of Leicester, Leicester, UK. |
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