In both the UK and Japan, heart failure (HF) is a common cause of hospitalisation, often prolongs hospital stay and is associated with increased death rates. Substantial differences in patients' characteristics, patient management and outcomes during hospitalisation of HF patients are known to exist between the Western and the Asian countries. However, the studies are limited by middle-sized datasets of HF patients and based on indirect comparisons. Simultaneous access to individual patient-level data in large-scale nationwide databases would enable the outcomes and the treatment strategy of patients with similar attributes in the UK and Japan to be compared rather than merely comparing averages based on previous published papers. We propose to evaluate patients with a specific type of heart failure in the UK and Japan.
As a national sample of current practice, we will use linked Clinical Practice Research Datalink (CPRD) data with Hospital Episode Statistics (HES) and Office for National Statistics (ONS) to undertake a cohort study to provide an accurate estimate of the number of people with hospitalised heart failure in the United Kingdom (UK). Japanese data will be sourced from the 2012-2015 Nationwide Claim-Based Database, the Japanese Registry Of All cardiac and vascular Diseases - Diagnosis Procedure Combination (JROAD-DPC). Each cohort (UK and Japan) will be analysed separately. All-cause mortality and proportion of patients receiving guideline directed medical therapy will be determined using Cox regression models. Multivariable Cox regression analysis will be used to estimate differences after adjusting for covariates (age, sex, chronic kidney disease, chronic obstructive pulmonary disease, diabetes mellitus, hypertension, coronary artery disease, atrial fibrillation, previous stroke, malignancy, obesity and depression). On completion of the analysis, pooled estimates will be compared across the datasets.
All-cause mortality; Length of hospital stay; Application rate of guideline-directed medical therapy.
Jennifer Quint - Chief Investigator - Imperial College London
Toshiyuki Nagai - Corresponding Applicant - Imperial College London
Varun Sundaram - Collaborator - Imperial College London
HES Accident and Emergency;HES Admitted Patient Care;ONS Death Registration Data