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Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit.

Mard S, Nielsen FE - Clin Epidemiol (2010)

Bottom Line: The recorded diagnoses from the NRP were compared with clinical data from the medical records.We found a relatively high PPV of the HF diagnosis in the NRP, and the NRP can therefore be a valuable tool for identification of patients with HF.However, using the NRP alone will not give a true picture of the cost and total burden of the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Herlev University Hospital, Denmark.

ABSTRACT

Objective: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.

Design: The NRP was used to identify patients with heart failure from July 1, 2005 to June 30, 2007. Heart failure was defined in accordance with European Society of Cardiology (ESC) guidelines. The recorded diagnoses from the NRP were compared with clinical data from the medical records.

Results: We identified 758 patients with a diagnosis of heart failure in the NRP. The PPV of a heart failure discharge diagnosis was 84.0% (95% confidence interval: 81.2-86.6). Patients with a discharge diagnosis of HF in the NRP without fulfilling the ESC criteria for HF had a better survival rate, a lower rate of rehospitalization, none were followed in the outpatient clinic, and they had a lower consumption of anticongestive medicine after discharge.

Conclusion: We found a relatively high PPV of the HF diagnosis in the NRP, and the NRP can therefore be a valuable tool for identification of patients with HF. However, using the NRP alone will not give a true picture of the cost and total burden of the disease.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival plot of patients classified as having no heart failure in relation to if echocardiography was performed.
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f2-clep-2-235: Kaplan–Meier survival plot of patients classified as having no heart failure in relation to if echocardiography was performed.

Mentions: The median follow-up time for survival was 2.9 years. Survival rate among patients with DHF was 0.41 (95% CI: 0.36–0.46) compared to 0.61 (95% CI: 0.46–0.72) among NHF patients (P < 0.001) (Figure 1). Restriction of survival analysis to NHF patients depending on echocardiographic examinations revealed a significant lower survival rate of 0.41 (95% CI: 0.21–0.60) among patients without echocardiography compared to patients with echocardiography who had a survival rate of 0.66 (95% CI: 0.47–0.80) with a dramatic decline in survival during the initial phase of the follow-up period (Figure 2).


Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit.

Mard S, Nielsen FE - Clin Epidemiol (2010)

Kaplan–Meier survival plot of patients classified as having no heart failure in relation to if echocardiography was performed.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2964079&req=5

f2-clep-2-235: Kaplan–Meier survival plot of patients classified as having no heart failure in relation to if echocardiography was performed.
Mentions: The median follow-up time for survival was 2.9 years. Survival rate among patients with DHF was 0.41 (95% CI: 0.36–0.46) compared to 0.61 (95% CI: 0.46–0.72) among NHF patients (P < 0.001) (Figure 1). Restriction of survival analysis to NHF patients depending on echocardiographic examinations revealed a significant lower survival rate of 0.41 (95% CI: 0.21–0.60) among patients without echocardiography compared to patients with echocardiography who had a survival rate of 0.66 (95% CI: 0.47–0.80) with a dramatic decline in survival during the initial phase of the follow-up period (Figure 2).

Bottom Line: The recorded diagnoses from the NRP were compared with clinical data from the medical records.We found a relatively high PPV of the HF diagnosis in the NRP, and the NRP can therefore be a valuable tool for identification of patients with HF.However, using the NRP alone will not give a true picture of the cost and total burden of the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Herlev University Hospital, Denmark.

ABSTRACT

Objective: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.

Design: The NRP was used to identify patients with heart failure from July 1, 2005 to June 30, 2007. Heart failure was defined in accordance with European Society of Cardiology (ESC) guidelines. The recorded diagnoses from the NRP were compared with clinical data from the medical records.

Results: We identified 758 patients with a diagnosis of heart failure in the NRP. The PPV of a heart failure discharge diagnosis was 84.0% (95% confidence interval: 81.2-86.6). Patients with a discharge diagnosis of HF in the NRP without fulfilling the ESC criteria for HF had a better survival rate, a lower rate of rehospitalization, none were followed in the outpatient clinic, and they had a lower consumption of anticongestive medicine after discharge.

Conclusion: We found a relatively high PPV of the HF diagnosis in the NRP, and the NRP can therefore be a valuable tool for identification of patients with HF. However, using the NRP alone will not give a true picture of the cost and total burden of the disease.

No MeSH data available.


Related in: MedlinePlus