title: [Survival of patients with heart failure in primary care].
abstract: OBJECTIVE
  To describe survival of patients with chronic heart failure (HF) followed up in primary care (PC) and analyse the effect of sex, age, clinical and health services factors, and income levels on survival.
  
  
  METHODS
  Longitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records.
  
  
  METHODS
  PC Area 7 of the Community of Madrid.
  
  
  METHODS
  Patients 24 year and older with at least one visit to PC in 2006.
  
  
  METHODS
  Incident cases of HF followed up from 2006 to 2010 or until death. Survival analysis with Kaplan-Meier and Cox proportional hazard multivariate regression.
  
  
  RESULTS
  A total of 3,061 cases were identified in a cohort of 227,984 patients. The survival rate was 65% at 5 years, with 519 patients dying with a median survival of 49 months. Factors associated with increased risk of mortality were, age (HR=1.04, 1.03-1.05), and having a diagnosis of ischemic heart disease (HR=1.45, 1.15- 1.78), or diabetes (HR=1.52, 1.17-1.95). Factors with a significant protective effect were: female sex (HR=0.72, 0.59-0.86), non-pensioner (HR=0.43, 0.23-0.84), having received the influenza vaccine annually (HR=0.01, 0.00-0.06), prescribed lipid-lowering drugs (HR=0.78, 0.61-0.99) or ACE inhibitors (HR=0.73, 0.60-0.88), and blood tests having been requested (HR=0.97, 0.95-1.00), X-rays (HR=0.81, 0.74-0.88), or electrocardiograms (HR=0.90, 0.81-0.99) in PC.
  
  
  CONCLUSIONS
  Data from patients with HF followed up in PC indicate that their survival is better than that obtained in other countries, supporting the argument of a better evolution of HF in Mediterranean countries.
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España; Unidad Docente de Ciencias Sanitarias y Médico Sociales, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España. Electronic address: asarria@isciii.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sarría-Santamera
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Prado-Galbarro
authors.affiliation: Unidad de Investigación, Sociedad Española de Reumatología, España.
authors.forename: María Auxiliadora
authors.initials: MA
authors.lastname: Martín-Martínez
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Rocío
authors.initials: R
authors.lastname: Carmona
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: Ana Estela
authors.initials: AE
authors.lastname: Gamiño Arroyo
authors.affiliation: Unidad de Investigación, Sociedad Española de Reumatología, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sánchez-Piedra
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España; Unidad de Investigación de Atención Primaria de Madrid, Madrid, España.
authors.forename: Sofía
authors.initials: S
authors.lastname: Garrido Elustondo
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España; Unidad de Investigación de Atención Primaria de Madrid, Madrid, España; Departamento de Medicina Preventiva, Universidad Rey Juan Carlos, Madrid, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: del Cura González
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D015996:Survival Rate
keywords: Atención primaria; Heart failure; Insuficiencia cardiaca; Primary care; Supervivencia; Survival