Table 4.
Adjusted HRs for the first HF emergency admission and death since time from 6 months after symptom (using comorbidity history as individual diseases)
| Variable | First HF emergency admission | Death | ||
| HR (95% CI) | P values | HR (95% CI) | P values | |
| Gender | ||||
| Male vs female | 0.98 (0.95 to 1.02) | 0.420 | 1.19 (1.13 to 1.26) | <0.001 |
| Age at symptom | ||||
| Per 5-year increase | 1.05 (1.04 to 1.07) | <0.001 | 1.24 (1.22 to 1.26) | <0.001 |
| HF diagnosis source | ||||
| Hospital vs primary care | NA | NA | 1.39 (1.29 to 1.49) | <0.001 |
| IMD quintile | 0.003 | 0.037 | ||
| 2 vs 1 | 1.04 (0.98 to 1.10) | 0.212 | 1.01 (0.93 to 1.09) | 0.842 |
| 3 vs 1 | 1.03 (0.97 to 1.10) | 0.307 | 0.97 (0.89 to 1.05) | 0.446 |
| 4 vs 1 | 1.09 (1.02 to 1.16) | 0.010 | 1.02 (0.94 to 1.11) | 0.654 |
| 5 vs 1 | 1.12 (1.05 to 1.20) | <0.001 | 1.11 (1.02 to 1.22) | 0.020 |
| Comorbidity | ||||
| Atrial fibrillation | 1.10 (1.04 to 1.16) | <0.001 | 1.12 (1.05 to 1.21) | 0.001 |
| Other arrhythmias | 1.00 (0.94 to 1.08) | 0.897 | 0.97 (0.88 to 1.07) | 0.512 |
| Myocardial infarction | 0.99 (0.90 to 1.08) | 0.766 | 1.15 (1.01 to 1.31) | 0.041 |
| Coronary artery disease | 0.99 (0.94 to 1.04) | 0.657 | 0.86 (0.80 to 0.92) | <0.001 |
| Myocarditis | 1.33 (0.98 to 1.81) | 0.066 | 0.89 (0.59 to 1.35) | 0.582 |
| Hypertension | 1.03 (0.99 to 1.08) | 0.136 | 0.90 (0.85 to 0.96) | <0.001 |
| Stroke | 1.03 0.95 to 1.11 | 0.478 | 1.11 (1.00 to 1.24) | 0.050 |
| Diabetes | 1.12 (1.07 to 1.18) | <0.001 | 1.09 (1.02 to 1.17) | 0.017 |
| Congenital heart disease | 1.27 (0.91 to 1.78) | 0.167 | 1.26 (0.81 to 1.97) | 0.309 |
| Chronic pulmonary disease | 1.09 (1.04 to 1.14) | <0.001 | 1.15 (1.08 to 1.22) | <0.001 |
| Peripheral vascular disease | 1.21 (1.12 to 1.30) | <0.001 | 1.36 (1.23 to 1.50) | <0.001 |
| Renal disease | 1.18 (1.13 to 1.24) | <0.001 | 1.15 (1.08 to 1.23) | <0.001 |
| Pathway | <0.001 | 0.071 | ||
| 1. (NICE-recommended) | 1 | 1 | ||
| 2. Guidance partially followed vs 1 | 1.11 (1.00 to 1.23) | 0.052 | 1.03 (0.89 to 1.18) | 0.700 |
| 3. Treatment only—HF medications but no NP/echo or referral vs 1 | 1.16 (1.05 to 1.28) | 0.003 | 1.03 (0.90 to 1.17) | 0.674 |
| 4. No NP/echo, referral or HF medications vs 1 | 1.30 (1.18 to 1.43) | <0.001 | 1.11 (0.97 to 1.27) | 0.123 |
| Symptom type | <0.001 | <0.001 | ||
| Breathlessness only vs fatigue only | 1.06 (1.01 to 1.12) | 0.027 | 1.19 (1.10 to 1.29) | <0.001 |
| Ankle swelling only vs fatigue only | 1.17 (1.10 to 1.25) | <0.001 | 1.09 (0.99 to 1.20) | 0.066 |
| Two or more symptoms vs fatigue only | 0.70 (0.60 to 0.82) | <0.001 | 0.96 (0.76 to 1.22) | 0.760 |
| Further consultation for HF symptom | ||||
| Received vs none | 1.01 (0.97 to 1.05) | 0.667 | 1.06 (1.00 to 1.12) | 0.060 |
HF, heart failure; IMD, Index of Multiple Deprivation; NA, not applicable.