Evidence map›Paper›PMID 34043762›Full record

ArticleEuropean heart journal. Quality of care & clinical outcomes2021

Substantial decline in hospital admissions for heart failure accompanied by increased community mortality during COVID-19 pandemic.

Ahmad Shoaib, Harriette G C Van Spall, Jianhua Wu, John G F Cleland, Theresa A McDonagh, Muhammad Rashid, Mohamed O Mohamed, Fozia Z Ahmed, John Deanfield, Mark de Belder and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Quality of care & clinical outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 2 pooled it
6.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.

  1. Pooled it
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  4. Implementation Fidelity of the Transitional Care Model: A Mixed Methods Study.Global implementation research and applications · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 2 countries.

Ahmad ShoaibKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.ORCID 0000-0003-0513-8319
Harriette G C Van SpallDepartment of Medicine, McMaster University, Hamilton, Canada.
Jianhua WuLeeds Institute for Data Analytics, University of Leeds, Leeds, UK.ORCID 0000-0001-6093-599X
John G F ClelandRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
Theresa A McDonaghSchool of Cardiovascular Medicine, Kings College, London, UK.ORCID 0000-0003-1305-9602
Muhammad RashidKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.ORCID 0000-0001-9725-1583
Mohamed O MohamedKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.
Fozia Z AhmedDepartment of Cardiology, Manchester University Hospitals NHS Trust, Manchester, UK.
John DeanfieldInstitute of Cardiovascular Sciences, University College London, London, UK.
Mark de BelderNational Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, UK.
Chris P GaleLeeds Institute for Data Analytics, University of Leeds, Leeds, UK.ORCID 0000-0003-4732-382X
Mamas A MamasKeele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.ORCID 0000-0001-9241-8890
Keele University · GBUniversity of Leeds · GBBarts Health NHS Trust · GBKing's College London · GBPopulation Health Research Institute · CAUniversity College London · GBUniversity of Glasgow · GBUniversity of Manchester · GB

Funding

Health Quality Improvement PartnershipNational Clinical Audit and Patient Outcomes ProgrammeNational Institute of Health ResearchThe National Heart Failure Audit Project
6 · The paper itself

Abstract

aimsWe hypothesized that a decline in admissions with heart failure during COVID-19 pandemic would lead to a reciprocal rise in mortality for patients with heart failure in the community. METHODS AND

resultsWe used National Heart Failure Audit data to identify 36 974 adults who had a hospital admission with a primary diagnosis of heart failure between February and May in either 2018, 2019, or 2020. Hospital admissions for heart failure in 2018/19 averaged 160/day but were much lower in 2020, reaching a nadir of 64/day on 27 March 2020 [incidence rate ratio (IRR): 0.40, 95% confidence interval (CI): 0.38-0.42]. The proportion discharged on guideline-recommended pharmacotherapies was similar in 2018/19 compared to the same period in 2020. Between 1 February-2020 and 31 May 2020, there was a 29% decrease in hospital deaths related to heart failure (IRR: 0.71, 95% CI: 0.67-0.75; estimated decline of 448 deaths), a 31% increase in heart failure deaths at home (IRR: 1.31, 95% CI: 1.24-1.39; estimated excess 539), and a 28% increase in heart failure deaths in care homes and hospices (IRR: 1.28, 95% CI: 1.18-1.40; estimated excess 189). All-cause, inpatient death was similar in the COVID-19 and pre-COVID-19 periods [odds ratio (OR): 1.02, 95% CI: 0.94-1.10]. After hospital discharge, 30-day mortality was higher in 2020 compared to 2018/19 (OR: 1.57, 95% CI: 1.38-1.78).

conclusionCompared with the rolling daily average in 2018/19, there was a substantial decline in admissions for heart failure but an increase in deaths from heart failure in the community. Despite similar rates of prescription of guideline-recommended therapy, mortality 30 days from discharge was higher during the COVID-19 pandemic period.

Indexed as

Communicable Disease ControlCOVID-19Heart FailureAged, 80 and overCause of DeathClinical AuditElectronic Health RecordsFemaleHospitalizationHospital MortalityHumansMaleMortalityQuality of Health CareSARS-CoV-2Severity of Illness IndexAcute heart failureCOVID-19Heart failureHospitalizationMortality

Identifiers

PMID34043762
PMCPMC8244536
OpenAlexW3164458084

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.