News in brief: Insight into Australian HFpEF and HFrEF outcomes; Irregular menstrual cycles linked to heart disease and diabetes; These discharge summary abbreviations cause confusion

HFpEF and HFrEF outcomes similar despite differing clinical profiles

Heart failure patients with preserved or reduced ejection fractions (HFpEF or HFrEF) have similar morbidity and mortality rates despite having different clinical profiles, a Victorian study has revealed.

The study of 1,132 HF patients found those with HFpEF were more likely to be female, older (81.5 ± 9.8 vs 73.2 ± 14.5 years) and have hypertension, atrial fibrillation, chronic obstructive airways disease or chronic kidney disease.

Meanwhile, HFrEF patients were more likely to have ischaemic heart disease with a history of myocardial infarction, percutaneous coronary intervention or cardiac bypass surgery.

Both patient sets had similar 30-day mortality and readmission rates, however (10.2% vs 7.8%, P = 0.19 and 22.1% vs 25.9%, P = 0.15, respectively).

The study “provides important insight into the burden of acute heart failure”, the authors wrote in Heart, Lung and Circulation.

Irregular menstrual cycles linked to heart disease and diabetes

Irregular menstrual cycles could be an early indicator for heart disease and diabetes, an Australian study suggests.

The study of 13,714 45 to 50-year old women found those with irregular menstrual cycles had a 20% higher risk of developing heart disease than those with regular cycles.

They were also more likely to develop diabetes, particularly (though not significantly after adjusting for all covariates) if they didn’t use hormone replacement therapy (hazard ratio: 1.17 and 1.30, respectively).

“These women may benefit from screening and prevention strategies as recommended by related guidelines such as the international evidence‐based guideline for the assessment and management of PCOS,” the authors concluded.

The full study is available in Clinical Endocrinology.

These discharge summary abbreviations cause confusion

Medical abbreviations used by specialists in hospital discharge summaries are often confusing to the GPs who receive them and also ambiguous for hospital colleagues and junior doctors, an Australian study has found.

A retrospective audit of 802 discharge summaries at a Queensland regional health service found that they contained an average of 17 abbreviations, and almost one in five GPs were unable to interpret at least one of them.

Almost all (94%) of GPs said that ambiguous abbreviations had a negative impact on patient care and 60% said they spent too much time of clarifying them. Abbreviations could also have multiple possible meanings in different contexts and led to confusion for 15% of junior doctors working in other departments of the same hospital, the study found.

While most had no problems with abbreviations such as Hb and IHD, the abbreviations that had widest range of misinterpretations or ‘don’t know’ responses included NAD, DEM, PE, LC, TGA, TCH and BAE.

The study authors said hospitals should adopt a standardised list of acceptable abbreviations for medical documentation, which is made available to both hospital medical staff and GPs.

They also noted that abbreviations were very location specific, with marked differences between those used by Melbourne and Sydney hospitals.

The findings are published in the Internal Medicine Journal.

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