Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study

Research output: Contribution to journalArticle

Authors

  • Clare J. Taylor
  • José M. Ordóñez-Mena
  • Sarah Lay-Flurrie
  • Nicholas R. Jones
  • Richard Hobbs

External organisations

  • University of Oxford

Abstract

Objectives: To report reliable short and long-term survival rate estimates for people with a diagnosis of heart failure and assess trends over time by year of diagnosis, hospitalisation and socioeconomic group.
Design: Population-based cohort study.
Setting: Primary Care, United Kingdom.
Population: Primary care data from 55,959 patients over age 45 years with a new diagnosis of heart failure, and 278, 679 age-sex matched controls, in the Clinical Practice Research Datalink between 1st January 2000 and 31st December 2017 were linked to inpatient Hospital Episode Statistics and the Office for National Statistics civil death registry. 
Main outcome measures: Survival rates at one, five and ten-years, and cause of death, for people with and without heart failure. Temporal trends in survival by year of diagnosis, hospitalisation and socioeconomic quintile. 
Results: Overall, one, five and ten-year survival rates increased by 6.6% (74.2% in 2000 to 80.8% in 2016), 7.2% (41.0% in 2000 to 48.2% in 2012) and 6.3% (19.8% in 2000 to 26.2% in 2007) respectively. There were 30,906 deaths in the heart failure group over the study period. Heart failure was listed on the death certificate in 13.093 (42.4%) of these patients, including 2,237 (7.2%) where it was the primary cause of death. Improvement in survival was greater for those not requiring hospitalisation around the time of diagnosis (median difference 2.4 years; 5.3 vs 2.9 years, p<0.0001). There was a deprivation gap in median survival of 2.4 years between the least and most deprived individuals (11.1 vs 8.7 years, p<0.0001).
Conclusions: Survival following a diagnosis of heart failure has shown only modest improvement in the 21st Century lagging behind other malignant conditions. New strategies to achieve timely diagnosis and treatment initiation in primary care for all socioeconomic groups should be a priority for future research and policy.

Details

Original languageEnglish
Article number1223
Pages (from-to)1-10
Number of pages10
JournalBMJ
Volume364
Issue number8187
Publication statusPublished - 13 Feb 2019