Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study

Figures & data

Table 1. Demographic and clinical characteristics according to the presence of a confirmed diagnosis of heart failure.

			Heart failure not confirmed (n = 276) n (%)
	Total population (n = 595) n (%)	Heart failure confirmed (n = 319) n (%)	Misdiagnosis n = 226	Unconfirmed n = 50	p
Demographic variables
Age (mean, SD)	78.3 (10.5)	77.3 (11.2)	79.63 (8.1)	78.96(10.7)	.02
Sex (women)	346 (58.1)	169 (52.9)	145 (64.1)	32 (65.2)	.05
Cardiovascular risk factors
Body mass index (mean, SD)	29.87 (5.2)	29.5 (5.2)	30.2 (5.4)	30.2 (4.5)	.52
Hypertension	499 (83.9)	260 (81.5)	201 (8.9)	38 (76)	.038
Diabetes mellitus	291 (48.9)	154 (48.3)	121 (53.5)	16 (32)	.69
Hypercholesterolaemia	377 (63.4)	208 (65.2)	143 (63.3)	26 (52)	.56
Smoking	45 (7.6)	29 (9.1)	14 (6.2)	2 (4)	.09
Cardiovascular comorbidities
Ischaemic heart disease	165 (27.7)	121 (37.9)	39 (17.2)	5 (10)	<.01
Atrial fibrillation	236 (39.7)	161 (50.4)	61 (26.9)	14 (28)	<.01
No cardiovascular comorbidities
Chronic kidney disease	152 (25.5)	93 (29.5)	46 (20.3)	13 (26)	.04
Chronic obstructive pulmonary disease	158 (26.5)	102 (31.9)	45 (19.9)	11 (22)	.01
Asthma	30 (5.0)	14 (4.4)	15 (6.6)	1 (2)	.58
Other variables
Visits by cardiologist	319 (53.6)	227 (71.1)	89 (39.4)	3 (6)	<.01
ECG normal	36 (6.1)	18 (5.6)	17 (7.5)	1 (0.2)	.65
Loop diuretics	321 (53.9)	207 (64.9)	114 (50.4)	12 (24)	<.01
Time since onset (years) [interquartile range]	4 [3–8]	4 [3–8]	4 [3–8]		.9

Table 2. Univariable and multivariable analysis and confirmed diagnosis of heart failure.

	Univariate analysis		Multivariate analysis^a
	OR (95%CI)	p	OR (95%CI)	p
Demographic variables
Age	0.96 (0.94–0.99)^b	.01	0.97 (0.95–0.99)	.04
Sex (women)	1.07 (0.58–1.95)	.82	0.74 (0.49–1.13)	.16
Cardiovascular risk factors
Body mass index	0.91 (0.92–1.02)	.21
Hypertension	1.03 (0.52–2.05)	.92
Diabetes mellitus	1.23 (0.74–2.05)	.40
Hypercholesterolaemia	0.93 (0.56–1.55)	.80
Smoking	0.71 (0.36–1.39)	.32
Cardiovascular comorbidities
Ischaemic heart disease	1.76 (1.03–3.18)	.04	2.17 (1.36–3.48)	.01
Atrial fibrillation	1.68 (1.01–2.78)	.04	2.01 (1.34–30.3)	.01
No cardiovascular comorbidities
Chronic kidney disease	1.16 (0.67–2.00)	.58
Chronic obstructive pulmonary disease	1.37 (0.74–2.54)	.32
Asthma	1.39 (0.50–3.90)	.53
Other variables
Visits by cardiologist	4.83 (2.92–7.99)	<.01	3.66 (2.46–5.47)	<.01
ECG normal	0.52 (0.11–2.16	.44
Loop diuretics	3.48 (2.07–5.84)	<.01	3.23 (2.14–4.89)	<.01
Time since onset	0.99 (0.93–1.05)	.77

^a Multivariate analysis has been adjusted for age, sex and variables statistically significant at the univariate.

^b Age: OR per year.

Figure 1. Validation of heart failure diagnosis. PCC: primary care centres, HF: heart failure.