Survival differences between heart failure in general practices and in hospitals

Area of Science:

• Cardiology
• General Practice
• Public Health

Background:

• Heart failure (HF) is a significant public health concern.
• Survival rates for heart failure patients vary depending on care setting.
• General practice (GP) data offers insights into community-based heart failure management.

Purpose of the Study:

• To compare the survival of patients with heart failure diagnosed in general practice (GP-HF) versus hospital (hospital-HF).
• To assess survival in patients with heart disease but without heart failure (non-HF) and a healthy control group.
• To identify predictors of mortality in community-dwelling heart failure patients.

Main Methods:

• A cross-sectional study with prospective follow-up (5.3–7.4 years) involving 2157 community participants.
• Participants were categorized into four groups: GP-HF, hospital-HF, non-HF, and control.
• Five-year survival and multivariate predictors of all-cause mortality were analyzed.

Main Results:

• Five-year survival rates were: control (76%), non-HF (71%), GP-HF (61%), and hospital-HF (39%).
• Median survival times were 6.8 years for GP-HF and 3.9 years for hospital-HF.
• Key mortality predictors included hospital-HF (HR 2.1), GP-HF (HR 1.7), higher age, and male sex.

Conclusions:

• Heart failure diagnosed in general practice is linked to poorer survival than in the general population.
• Survival for GP-HF patients is better than for those previously treated for heart failure in a hospital setting.
• This highlights the importance of understanding HF patient trajectories across different care environments.