Comparative analysis of data from the outpatient electronic medical records of patients of different ages with chronic heart failure: results and problems

Objective. To determine clinical features and management tactics in patients with chronic heart failure (CHF) in three age groups, by analyzing their electronic medical records (EMRs).

Material and methods. EHRs were analyzed in 683 patients from healthcare facilities in the urban districts of the Moscow Region who sought medical assistance in 2021, in whom ICD-10 Code I50 (heart failure) was indicated as one of the diagnosis codes (for complications). For analysis, three groups were formed: 18–59 year-olds; 60–70 year-olds; and over 71-year-olds.

Results. Statistically significant differences were found in the frequency of recording hypertension (85, 90, and 94%, respectively), cardiomyopathy (5.6, 0.8, and 0.4%), prior COVID-19 infection (78, 26, and 17%), and in the rate of hospitalization for any cause (52, 43, and 63%). At the same time, there were no differences in hospitalization rates for diagnosed COVID-19 (4.4, 4.5, and 4.6%, respectively). The proportion of women in the sample increased significantly with age (32%, 49%, and 65%). The frequency of consultations in the third-level institutions or the Federal Center was 86; 79 and 69%, respectively (p < 0.0001). There were no differences in the frequency of using different groups of drugs (22.8; 20.2 and 22.9%), including triple therapy. The discussion presents the problems of evaluating patient management tactics based on EHRs.

Conclusion. The clinical and gender characteristics of patients with CHF and their management tactics differ in different age groups. However, the unstructured filling in of EHRs and a single data upload fail to fully assess the compliance of management tactics in CHF patients with clinical practice guidelines and to judge the efficiency of patient treatment.