• Antonio Sarría-Santamera, Francisco Javier Prado-Galbarro, María Auxiliadora Martín-Martínez, Rocío Carmona, Ana Estela Gamiño Arroyo, Carlos Sánchez-Piedra, Garrido ElustondoSofíaSRed de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España; Unidad de Investigación de Atención Primaria de Madrid, Madrid, España., and Isabel del Cura González.
• 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.
• Aten Primaria. 2015 Aug 1; 47 (7): 438-45.

ObjectiveTo 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.DesignLongitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records.SettingPC Area 7 of the Community of Madrid.ParticipantsPatients 24 year and older with at least one visit to PC in 2006.Principal MeasurementIncident cases of HF followed up from 2006 to 2010 or until death. Survival analysis with Kaplan-Meier and Cox proportional hazard multivariate regression.ResultsA 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.ConclusionsData 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.Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

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