© 2005 European Society of Cardiology
The validity of a diagnosis of heart failure in a hospital discharge register
a Department of Public Health and Caring Sciences, Section of Geriatrics Uppsala University, Box 609, SE-75125 Uppsala, Sweden
b Department of Medical Sciences Uppsala University, Sweden
c Astra Zeneca R&D Mölndal, Sweden
* Corresponding author. Visiting address: Kälsängsgränd 10D, 753 19, Uppsala, Sweden. Tel.: +46 18 6117662; fax: +46 18 6117976. E-mail address: erik.ingelsson{at}pubcare.uu.se
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Abstract |
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Background and aims: The accuracy of a diagnosis of heart failure (HF) in hospital discharge registers is largely unknown. We aimed to determine the validity of such a diagnosis in the Swedish hospital discharge register.
Methods and results: In a population-based study of 2322 middle-aged men (the ULSAM study), 321 participants were diagnosed with HF according to the Swedish hospital discharge register, during a median follow-up time of 29 years. A review board examined the validity of the diagnosis according to the European Society of Cardiology definition of HF.
Eighty-two percent of the possible cases were classified as having definite HF. An echocardiographic examination increased the validity to 88%. For patients treated at an internal medicine or cardiology clinic the validity was 86% and 91%, respectively. If HF was the primary diagnosis, the validity was 95%, irrespective of clinic type.
Conclusion: The HF diagnosis in the Swedish hospital discharge register appears slightly less precise than for acute myocardial infarction and stroke. For population-based research, only those with a primary diagnosis of HF in the hospital discharge register should be regarded as definite HF cases, or alternatively the cases should be validated individually.
Key Words: Heart failure • Hospital discharge register • Epidemiology • Validity
Received April 19, 2004; Revised October 25, 2004; Accepted December 20, 2004
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