Mortality after admission for heart failure in the UK compared with Japan

Toshiyuki Nagai, Varun Sundaram, Kieran Rothnie, Jennifer Kathleen Quint, Ahmad Shoaib, Yasuyuki Shiraishi, Shun Kosaka, Susan Piper, Theresa A. McDonagh, Suzanna Marie C. Hardman, Ayumi Goda, Atsushi Mizuno, Takashi Kohno, Alan S. Rigby, Tsutomu Yoshikawa, Andrew L. Clark, Toshihisa Anzai, John G.F. Cleland

研究成果: Article

2 引用 (Scopus)

抄録

Objective Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical analysis of HHF registries and variable selection from a systematic literature review. Methods and results IPLD from registries of HHF in Japan (n=3781) and the UK (n=894) were obtained. A systematic literature review identified 23 models for predicting outcome of HHF. Five variables appearing in 10 or more reports were strongly related to prognosis (systolic blood pressure, serum sodium concentration, age, blood urea nitrogen and creatinine). To compare mortality in the UK and Japan, variables were imputed in a propensity model using inverse probability of treatment weighting (IPTW) and IPTW with logistic regression (doubly robust IPTW). Overall, patients in the UK were sicker and in-patient and post-discharge mortalities were greater, suggesting that the threshold for hospital admission was higher. Covariate-adjusted in-hospital mortality was similar in the UK and Japan (IPTW OR: 1.14, 95% CI 0.70 to 1.86), but 180-day postdischarge mortality was substantially higher in the UK (doubly robust IPTW OR: 2.33, 95% CI 1.58 to 3.43). Conclusions Despite robust methods to adjust for differences in patient characteristics and disease severity, HHF patients in the UK have roughly twice the mortality at 180 days compared with those in Japan. Similar analyses should be done using other data sets and in other countries to determine the consistency of these findings and identify factors that might inform healthcare policy and improve outcomes.

元の言語English
記事番号e000811
ジャーナルOpen Heart
5
発行部数2
DOI
出版物ステータスPublished - 2018 8 1

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Japan
Heart Failure
Mortality
Registries
Blood Pressure
Therapeutics
Patient Discharge
Blood Urea Nitrogen
Hospital Mortality
Creatinine
Logistic Models
Sodium
Delivery of Health Care
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

これを引用

Nagai, T., Sundaram, V., Rothnie, K., Quint, J. K., Shoaib, A., Shiraishi, Y., ... Cleland, J. G. F. (2018). Mortality after admission for heart failure in the UK compared with Japan. Open Heart, 5(2), [e000811]. https://doi.org/10.1136/openhrt-2018-000811

Mortality after admission for heart failure in the UK compared with Japan. / Nagai, Toshiyuki; Sundaram, Varun; Rothnie, Kieran; Quint, Jennifer Kathleen; Shoaib, Ahmad; Shiraishi, Yasuyuki; Kosaka, Shun; Piper, Susan; McDonagh, Theresa A.; Hardman, Suzanna Marie C.; Goda, Ayumi; Mizuno, Atsushi; Kohno, Takashi; Rigby, Alan S.; Yoshikawa, Tsutomu; Clark, Andrew L.; Anzai, Toshihisa; Cleland, John G.F.

:: Open Heart, 巻 5, 番号 2, e000811, 01.08.2018.

研究成果: Article

Nagai, T, Sundaram, V, Rothnie, K, Quint, JK, Shoaib, A, Shiraishi, Y, Kosaka, S, Piper, S, McDonagh, TA, Hardman, SMC, Goda, A, Mizuno, A, Kohno, T, Rigby, AS, Yoshikawa, T, Clark, AL, Anzai, T & Cleland, JGF 2018, 'Mortality after admission for heart failure in the UK compared with Japan', Open Heart, 巻. 5, 番号 2, e000811. https://doi.org/10.1136/openhrt-2018-000811
Nagai T, Sundaram V, Rothnie K, Quint JK, Shoaib A, Shiraishi Y その他. Mortality after admission for heart failure in the UK compared with Japan. Open Heart. 2018 8 1;5(2). e000811. https://doi.org/10.1136/openhrt-2018-000811
Nagai, Toshiyuki ; Sundaram, Varun ; Rothnie, Kieran ; Quint, Jennifer Kathleen ; Shoaib, Ahmad ; Shiraishi, Yasuyuki ; Kosaka, Shun ; Piper, Susan ; McDonagh, Theresa A. ; Hardman, Suzanna Marie C. ; Goda, Ayumi ; Mizuno, Atsushi ; Kohno, Takashi ; Rigby, Alan S. ; Yoshikawa, Tsutomu ; Clark, Andrew L. ; Anzai, Toshihisa ; Cleland, John G.F. / Mortality after admission for heart failure in the UK compared with Japan. :: Open Heart. 2018 ; 巻 5, 番号 2.
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abstract = "Objective Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical analysis of HHF registries and variable selection from a systematic literature review. Methods and results IPLD from registries of HHF in Japan (n=3781) and the UK (n=894) were obtained. A systematic literature review identified 23 models for predicting outcome of HHF. Five variables appearing in 10 or more reports were strongly related to prognosis (systolic blood pressure, serum sodium concentration, age, blood urea nitrogen and creatinine). To compare mortality in the UK and Japan, variables were imputed in a propensity model using inverse probability of treatment weighting (IPTW) and IPTW with logistic regression (doubly robust IPTW). Overall, patients in the UK were sicker and in-patient and post-discharge mortalities were greater, suggesting that the threshold for hospital admission was higher. Covariate-adjusted in-hospital mortality was similar in the UK and Japan (IPTW OR: 1.14, 95{\%} CI 0.70 to 1.86), but 180-day postdischarge mortality was substantially higher in the UK (doubly robust IPTW OR: 2.33, 95{\%} CI 1.58 to 3.43). Conclusions Despite robust methods to adjust for differences in patient characteristics and disease severity, HHF patients in the UK have roughly twice the mortality at 180 days compared with those in Japan. Similar analyses should be done using other data sets and in other countries to determine the consistency of these findings and identify factors that might inform healthcare policy and improve outcomes.",
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T1 - Mortality after admission for heart failure in the UK compared with Japan

AU - Nagai, Toshiyuki

AU - Sundaram, Varun

AU - Rothnie, Kieran

AU - Quint, Jennifer Kathleen

AU - Shoaib, Ahmad

AU - Shiraishi, Yasuyuki

AU - Kosaka, Shun

AU - Piper, Susan

AU - McDonagh, Theresa A.

AU - Hardman, Suzanna Marie C.

AU - Goda, Ayumi

AU - Mizuno, Atsushi

AU - Kohno, Takashi

AU - Rigby, Alan S.

AU - Yoshikawa, Tsutomu

AU - Clark, Andrew L.

AU - Anzai, Toshihisa

AU - Cleland, John G.F.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objective Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical analysis of HHF registries and variable selection from a systematic literature review. Methods and results IPLD from registries of HHF in Japan (n=3781) and the UK (n=894) were obtained. A systematic literature review identified 23 models for predicting outcome of HHF. Five variables appearing in 10 or more reports were strongly related to prognosis (systolic blood pressure, serum sodium concentration, age, blood urea nitrogen and creatinine). To compare mortality in the UK and Japan, variables were imputed in a propensity model using inverse probability of treatment weighting (IPTW) and IPTW with logistic regression (doubly robust IPTW). Overall, patients in the UK were sicker and in-patient and post-discharge mortalities were greater, suggesting that the threshold for hospital admission was higher. Covariate-adjusted in-hospital mortality was similar in the UK and Japan (IPTW OR: 1.14, 95% CI 0.70 to 1.86), but 180-day postdischarge mortality was substantially higher in the UK (doubly robust IPTW OR: 2.33, 95% CI 1.58 to 3.43). Conclusions Despite robust methods to adjust for differences in patient characteristics and disease severity, HHF patients in the UK have roughly twice the mortality at 180 days compared with those in Japan. Similar analyses should be done using other data sets and in other countries to determine the consistency of these findings and identify factors that might inform healthcare policy and improve outcomes.

AB - Objective Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical analysis of HHF registries and variable selection from a systematic literature review. Methods and results IPLD from registries of HHF in Japan (n=3781) and the UK (n=894) were obtained. A systematic literature review identified 23 models for predicting outcome of HHF. Five variables appearing in 10 or more reports were strongly related to prognosis (systolic blood pressure, serum sodium concentration, age, blood urea nitrogen and creatinine). To compare mortality in the UK and Japan, variables were imputed in a propensity model using inverse probability of treatment weighting (IPTW) and IPTW with logistic regression (doubly robust IPTW). Overall, patients in the UK were sicker and in-patient and post-discharge mortalities were greater, suggesting that the threshold for hospital admission was higher. Covariate-adjusted in-hospital mortality was similar in the UK and Japan (IPTW OR: 1.14, 95% CI 0.70 to 1.86), but 180-day postdischarge mortality was substantially higher in the UK (doubly robust IPTW OR: 2.33, 95% CI 1.58 to 3.43). Conclusions Despite robust methods to adjust for differences in patient characteristics and disease severity, HHF patients in the UK have roughly twice the mortality at 180 days compared with those in Japan. Similar analyses should be done using other data sets and in other countries to determine the consistency of these findings and identify factors that might inform healthcare policy and improve outcomes.

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