Programme no. 157-P
Public Health
Heart failure in patients with chronic obstructive pulmonary disease in a Swedish population – a register based study.
Elzbieta Kaszuba*1, Håkan Odeberg2, Lennart Råstam3, Anders Halling4
1Clinical Sciences,Lund University,Malmö,Sweden, 2Clinical Sciences,Lund University,Malmö,Sweden, 3Clinical Sciences,Lund University,Malmö,Sweden, 4Department of Public Health,University of Southern Denmark,Odense,Denmark
* = Presenting author
Objectives: We aimed to study prevalence of coexisting heart failure and COPD in a Swedish population. Further aims were to describe other comorbidity in these patients and where patients with coexisting heart failure and COPD receive care: primary, secondary health care or both.
Background: Despite that heart failure and chronic obstructive pulmonary disease (COPD) often coexist and have serious economic and clinical implications, both diseases have mostly been studied separately.
Results: The prevalence of the diagnosis of heart failure in patients with COPD was 18.8% while only 1.6% in patients without COPD. Levels of other comorbidity were significantly higher (p < 0.001) in patients with coexisting heart failure and COPD compared with patients with heart failure or COPD alone. Primary health care delivered care to 20.7% of patients with coexisting heart failure and COPD and to a further 21.7% together with secondary health care. Among patients with the diagnosis of heart failure alone 36.2% received care in primary health only and 21.5% in both primary and secondary health care. The share of total care between primary and secondary health care varied depending on levels of comorbidity.
Material/Methods: A register-based, cross-sectional study. The study included, the total population older than 19 years (313977 inhabitants) living in Östergötland County in Sweden. The data was obtained from the Care Data Warehouse register from the year 2006. The diagnosis-based Adjusted Clinical Groups (ACG) Case-Mix System 7.1 was used to describe comorbidity. Comorbidity was measured when both the diagnoses heart failure and COPD were excluded and is referred to as other comorbidity.

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Conclusion: Patients with coexisting diagnosis of heart failure and COPD are common in a Swedish population. Patients with coexisting heart failure and COPD have higher comorbidity levels than patients with heart failure or COPD alone. Primary health care in Sweden participates to a great extent in care of patients with heart failure and coexisting heart failure and COPD.
Points for discussion: Coexisting heart failure and COPD – a challenge for future health care.

The usefulness of register based data for epidemiological studies.