More 'malignant' than cancer? Five-year survival following a first admission for heart failure

Eur J Heart Fail. 2001 Jun;3(3):315-22. doi: 10.1016/s1388-9842(00)00141-0.

Abstract

Background: The prognostic impact of heart failure relative to that of 'high-profile' disease states such as cancer, within the whole population, is unknown.

Methods: All patients with a first admission to any Scottish hospital in 1991 for heart failure, myocardial infarction or the four most common types of cancer specific to men and women were identified. Five-year survival rates and associated loss of expected life-years were then compared.

Results: In 1991, 16224 men had an initial hospitalisation for heart failure (n=3241), myocardial infarction (n=6932) or cancer of the lung, large bowel, prostate or bladder (n=6051). Similarly, 14842 women were admitted for heart failure (n=3606), myocardial infarction (n=4916), or cancer of the breast, lung, large bowel or ovary (n=6320). With the exception of lung cancer, heart failure was associated with the poorest 5-year survival rate (approximately 25% for both sexes). On an adjusted basis, heart failure was associated with worse long-term survival than bowel cancer in men (adjusted odds ratio, 0.89; 95% CI, 0.82-0.97; P<0.01) and breast cancer in women (odds ratio, 0.59; 95% CI, 0.55-0.64; P<0.001). The overall population rate of expected life-years lost due to heart failure in men was 6.7 years/1000 and for women 5.1 years/1000.

Conclusion: With the notable exception of lung cancer, heart failure is as 'malignant' as many common types of cancer and is associated with a comparable number of expected life-years lost.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / complications
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / mortality
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Heart Failure / complications*
  • Heart Failure / epidemiology
  • Heart Failure / mortality*
  • Humans
  • Life Expectancy
  • Lung Neoplasms / complications
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / mortality
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / mortality
  • Neoplasms / complications*
  • Neoplasms / epidemiology
  • Neoplasms / mortality*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / mortality
  • Patient Admission*
  • Retrospective Studies
  • Scotland / epidemiology
  • Sex Factors
  • Survival Analysis
  • Survival Rate