Association between process performance measures and 1-year mortality among patients with incident heart failure: a Danish nationwide study

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Association between process performance measures and 1-year mortality among patients with incident heart failure : a Danish nationwide study. / Nakano, Anne; Vinter, Nicklas; Egstrup, Kenneth; Svendsen, Marie Louise; Schjødt, Inge; Johnsen, Søren Paaske.

In: European heart journal. Quality of care & clinical outcomes, Vol. 5, No. 1, 01.2019, p. 28-34.

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Nakano, Anne ; Vinter, Nicklas ; Egstrup, Kenneth ; Svendsen, Marie Louise ; Schjødt, Inge ; Johnsen, Søren Paaske. / Association between process performance measures and 1-year mortality among patients with incident heart failure : a Danish nationwide study. In: European heart journal. Quality of care & clinical outcomes. 2019 ; Vol. 5, No. 1. pp. 28-34.

Bibtex

@article{571d3eb45b3b4f7995f93c23342c0188,
title = "Association between process performance measures and 1-year mortality among patients with incident heart failure: a Danish nationwide study",
abstract = "Aims: To examine the association between fulfilment of performance measures supported by clinical guidelines recommendations and 1-year mortality among patients with incident heart failure (HF) in Denmark.Methods and results: A nationwide population-based follow-up study based on the Danish Heart Failure Registry. All Danish hospital departments caring for patients with HF. We identified 24,308 in-and outpatients diagnosed with HF from 2003 to 2010. Quality of care was defined as receiving the guideline recommended processes of care: use of echocardiography, New-York-Heart-Association -classification, treatment with angiotensin-converting-enzyme inhibitors/angiotensin-II-receptor blocker, betablockers, physical training and patient education.Main outcome measure: 1-year mortality. We used multiple imputation and multivariable Cox Proportional Hazard Regression to compute Hazard Ratios (HRs) for 1-year mortality adjusted for potential confounding factors. Within 1 year, 17.1{\%} of the patients died and the adjusted HRs ranged from 0.61 (95{\%} Confidence Interval ((CI) 0.55-0.67)) for patient education to 0.99 (95{\%} CI 0.90-1.10) for betablocker therapy. The association between meeting more performance measures and 1-year mortality appeared to follow a dose-response pattern: Using 0-25{\%} of fulfilled measures as reference, patients who fulfilled 76- 100{\%} of the performance measures had an adjusted HR of 0.43 (95{\%} CI 0.38-0.48), while the adjusted HR was 0.96 (95{\%} CI 0.86-1.07) for patients who fulfilled between 26-50{\%} of the performance measures.Conclusion: Meeting process performance measures, which reflect care in concordance with clinical guideline recommendations, was associated with substantially lower 1-year mortality among patients with incident HF.",
author = "Anne Nakano and Nicklas Vinter and Kenneth Egstrup and Svendsen, {Marie Louise} and Inge Schj{\o}dt and Johnsen, {S{\o}ren Paaske}",
year = "2019",
month = "1",
doi = "10.1093/ehjqcco/qcy041",
language = "English",
volume = "5",
pages = "28--34",
journal = "European heart journal. Quality of care & clinical outcomes",
issn = "2058-1742",
publisher = "Oxford University Press",
number = "1",

}

RIS

TY - JOUR

T1 - Association between process performance measures and 1-year mortality among patients with incident heart failure

T2 - a Danish nationwide study

AU - Nakano, Anne

AU - Vinter, Nicklas

AU - Egstrup, Kenneth

AU - Svendsen, Marie Louise

AU - Schjødt, Inge

AU - Johnsen, Søren Paaske

PY - 2019/1

Y1 - 2019/1

N2 - Aims: To examine the association between fulfilment of performance measures supported by clinical guidelines recommendations and 1-year mortality among patients with incident heart failure (HF) in Denmark.Methods and results: A nationwide population-based follow-up study based on the Danish Heart Failure Registry. All Danish hospital departments caring for patients with HF. We identified 24,308 in-and outpatients diagnosed with HF from 2003 to 2010. Quality of care was defined as receiving the guideline recommended processes of care: use of echocardiography, New-York-Heart-Association -classification, treatment with angiotensin-converting-enzyme inhibitors/angiotensin-II-receptor blocker, betablockers, physical training and patient education.Main outcome measure: 1-year mortality. We used multiple imputation and multivariable Cox Proportional Hazard Regression to compute Hazard Ratios (HRs) for 1-year mortality adjusted for potential confounding factors. Within 1 year, 17.1% of the patients died and the adjusted HRs ranged from 0.61 (95% Confidence Interval ((CI) 0.55-0.67)) for patient education to 0.99 (95% CI 0.90-1.10) for betablocker therapy. The association between meeting more performance measures and 1-year mortality appeared to follow a dose-response pattern: Using 0-25% of fulfilled measures as reference, patients who fulfilled 76- 100% of the performance measures had an adjusted HR of 0.43 (95% CI 0.38-0.48), while the adjusted HR was 0.96 (95% CI 0.86-1.07) for patients who fulfilled between 26-50% of the performance measures.Conclusion: Meeting process performance measures, which reflect care in concordance with clinical guideline recommendations, was associated with substantially lower 1-year mortality among patients with incident HF.

AB - Aims: To examine the association between fulfilment of performance measures supported by clinical guidelines recommendations and 1-year mortality among patients with incident heart failure (HF) in Denmark.Methods and results: A nationwide population-based follow-up study based on the Danish Heart Failure Registry. All Danish hospital departments caring for patients with HF. We identified 24,308 in-and outpatients diagnosed with HF from 2003 to 2010. Quality of care was defined as receiving the guideline recommended processes of care: use of echocardiography, New-York-Heart-Association -classification, treatment with angiotensin-converting-enzyme inhibitors/angiotensin-II-receptor blocker, betablockers, physical training and patient education.Main outcome measure: 1-year mortality. We used multiple imputation and multivariable Cox Proportional Hazard Regression to compute Hazard Ratios (HRs) for 1-year mortality adjusted for potential confounding factors. Within 1 year, 17.1% of the patients died and the adjusted HRs ranged from 0.61 (95% Confidence Interval ((CI) 0.55-0.67)) for patient education to 0.99 (95% CI 0.90-1.10) for betablocker therapy. The association between meeting more performance measures and 1-year mortality appeared to follow a dose-response pattern: Using 0-25% of fulfilled measures as reference, patients who fulfilled 76- 100% of the performance measures had an adjusted HR of 0.43 (95% CI 0.38-0.48), while the adjusted HR was 0.96 (95% CI 0.86-1.07) for patients who fulfilled between 26-50% of the performance measures.Conclusion: Meeting process performance measures, which reflect care in concordance with clinical guideline recommendations, was associated with substantially lower 1-year mortality among patients with incident HF.

U2 - 10.1093/ehjqcco/qcy041

DO - 10.1093/ehjqcco/qcy041

M3 - Journal article

VL - 5

SP - 28

EP - 34

JO - European heart journal. Quality of care & clinical outcomes

JF - European heart journal. Quality of care & clinical outcomes

SN - 2058-1742

IS - 1

ER -