Validation of the heart failure diagnosis in Sahlgrenska University Hospital in 2000 - 2012 and an examination of co-morbidities present

Abstract

Master thesis, Programme in Medicine TITLE: alidation of the heart failure diagnosis in Sahlgrenska University Hospital in 2000 - 2012 and an examination of co-morbidities present. Background: Heart failure (HF) is a complex clinical syndrome, characterized by a variety of symptoms. Patients with HF are often old and have several co-morbidities. HF is a common disease with high mortality and morbidity, and with a large impact on quality of life. Therefore, diagnostic accuracy is important. Aim: To validate the HF diagnosis in patients hospitalized in Sahlgrenska University Hospital in Gothenburg under 2000- 2012, and also to examine whether co-morbidities may affect the validity of the diagnosis. Method: All patients hospitalized with the diagnosis of HF in Sahlgrenska University Hospital in 2000- 2012 were identified (27 517 patients). 1 100 patients were randomly selected and studied. Their diagnosis was validated according to the European Society of Cardiology (ESC) diagnostic guidelines. The co-morbidities studied were ischemic heart disease (IHD), diabetes mellitus (DM), hypertension, hyper- and hypothyreosis, asthmatic or chronic obstructive pulmonary disease (COPD), kidney failure, cardiomyopathy, atrial flutter-/ defibrillation, systemic inflammatory disease and drug-/ alcohol abuse. Results: Finally, 136 patients were excluded, mainly due to incomplete information or missing records. The validation of the HF diagnosis in the population studied (964 patients) were definite in 62.1 %, probable in 32.3 % and miscoded in 5.6 % of cases. No significant difference was found in the validity of the diagnosis when comparing the subgroups of co-morbidities to the whole study population. Conclusions: The overall validity of the HF diagnosis was 94.4 % which is quite high, and in line with earlier validation studies.

Keywords: Heart failure, validation, diagnosis, co-morbidities