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NATIONAL HEART FAILURE AUDIT

Application Notes

Dataset version 3Valid from 26th March 2012

Contents

National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 1

Contents1 Introduction ______________________________________________________________________________________________________3

2 Contact details ___________________________________________________________________________________________________4

3 Data collection ___________________________________________________________________________________________________5

3.1 Which patients to include _____________________________________________________________________________________5

3.2 Number of patients __________________________________________________________________________________________5

3.3 Ensuring representativeness __________________________________________________________________________________5

3.4 Patient confidentiality and identification ________________________________________________________________________5

3.5 Patient consent _____________________________________________________________________________________________5

3.6 Using the data application and submitting data _________________________________________________________________6

3.7 Use of National Heart Failure Audit data ________________________________________________________________________6

3.8 Ensuring data quality ________________________________________________________________________________________6

3.9 Reporting timescale _________________________________________________________________________________________6

4 The dataset _______________________________________________________________________________________________________7

4.1 The data application _________________________________________________________________________________________7

4.2 New core fields _____________________________________________________________________________________________8

4.3 New fields __________________________________________________________________________________________________9

4.4 New options within fields ___________________________________________________________________________________ 10

4.5 Deleted fields _____________________________________________________________________________________________ 10

5 Core dataset definitions _________________________________________________________________________________________ 11

5.1 Patient record _____________________________________________________________________________________________ 11

5.2 Admission/readmission ____________________________________________________________________________________ 11

5.2.1 Admission and symptoms ___________________________________________________________________________ 11

5.2.2 History ____________________________________________________________________________________________ 12

5.2.3 Physical examination ________________________________________________________________________________ 12

5.2.4 Investigations ______________________________________________________________________________________ 12

5.2.5 Treatment on discharge ______________________________________________________________________________ 13

5.2.6 Diagnosis __________________________________________________________________________________________ 14

5.2.7 Discharge __________________________________________________________________________________________ 14

5.2.8 User defined fields __________________________________________________________________________________ 15

5.3 Unscheduled event ________________________________________________________________________________________ 15

5.4 Life status ________________________________________________________________________________________________ 15

6 Clinical guidelines _______________________________________________________________________________________________ 17

7 National Heart Failure Audit pro forma, version 3 __________________________________________________________________ 22

8 National Heart Failure Audit core dataset, version 3 _______________________________________________________________ 24

9 National Heart Failure Audit full dataset, version 3 _________________________________________________________________ 33

Contents

2 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012

Introduction & contact details


1 IntroductionThe National Heart Failure Audit was established in 2007 with the

aim of collecting and disseminating national comparative data

on the diagnosis, treatment and management of heart failure

patients in secondary care. National clinical audit data is reported

to hospitals and Trusts, Cardiac Networks and NHS regulatory

bodies in order to drive the improvement of heart failure services

and to achieve better outcomes for patients.

The National Heart Failure Audit is managed by NICOR (the

National Institute for Cardiovascular Outcomes Research), which

is based in the Institute of Cardiovascular Science at University

College London. NICOR manages seven national cardiac clinical

audits. Specialist clinical knowledge and clinical leadership for

the National Heart Failure Audit is provided by the British Society

of Heart Failure and the audit Project Board, which determines

the strategic direction and development of the project, and which

includes stakeholders from hospitals, Cardiac Networks and

patient groups.

The audit is funded and commissioned by HQIP (the Healthcare

Quality Improvement Partnership) and is one of 29 audits in

the National Clinical Audit and Patient Outcomes Programme

(NCAPOP).1 Data from the audit is included in clinical indicators

that are used by regulatory bodies such as the Care Quality

Commission and the NHS Information Centre to measure

performance of NHS organisations.

1 http://www.hqip.org.uk/national-clinical-audit-and-patient-outcomes-programme.

In 2010/11 85% of all Trusts in England and Wales submitted

data on 54% of all patients discharged from hospital with a

primary diagnosis of heart failure (compared with HES data).

Building on this foundation, the audit hopes to include data from

90% of Trusts by 2011/12, which will not be possible without the

continued support and participation of hospitals across the UK.

We are very grateful to all of our colleagues who have submitted

data and taken part in the audit over the last 5 years.

This document details a revised dataset, version 3, which came

into effect on 26th March 2012, and which replaces the existing

version 2 of the dataset. The new dataset contains a series of

additional data items that will allow the audit to monitor the

implementation of the NICE quality standard for chronic heart

failure which was published last year. Additional fields will also

enable the risk adjustment of data, which is necessary for the

development of accurate comparative mortality analysis. The

aim of the revision is firstly to facilitate more comprehensive

feedback, giving hospitals more data about their own

performance and their implementation of recommended clinical

guidance, and secondly to allow comparative Trust level data to

be reported to stakeholders and the public.

http://www.hqip.org.uk/national-clinical-audit-and-patient-outcomes-programme/

Introduction & contact details


2 Contact detailsClinical queries

The National Heart Failure Audit provides a helpdesk during

working hours for all clinical queries and general enquiries about

the audit, managed by Polly Mitchell, the audit project manager.

If your hospital does not currently participate in the audit, please

contact Polly to set up an account.

Email: [email protected]

Tel: 020 3108 3927

Technical queries

All technical enquiries concerning Lotus Notes or any other IT

issues should be directed to the NICOR helpdesk.


Tel: 020 3108 1978

General enquiries

National Heart Failure Audit

NICOR, 3rd Floor, 170 Tottenham Court Road, London W1T 7HA


Tel: 020 3108 3929

mailto:[email protected]



Data collection


3 Data collection3.1 Which patients to include

The audit collects data on all patients discharged from hospital

with a diagnosis of heart failure in the primary position (the main

condition treated or investigated during the episode of care) for

the following ICD-10 codes:2

I50.0 Congestive heart failure

I50.1 Left ventricular failure

I50.9 Heart failure, unspecified

I11.0 Hypertensive heart disease with (congestive) heart

failure

I42.0 Dilated cardiomyopathy

I25.5 Ischaemic cardiomyopathy

I42.9 Cardiomyopathy, unspecified.

The National Heart Failure Audit reports only on heart failure

patients in secondary care; Primary Care Trusts can use the

database for local auditing, but as yet their data will not be

included in the audit.

3.2 Number of patients

Ideally hospitals should be submitting data on all of their heart

failure patients, but participation in the audit is defined as

each Trust submitting a minimum of 20 cases per month to

the database. If a Trust discharges fewer than 20 heart failure

patients in a month, the total number of cases should be

submitted. The percentage of the overall heart failure patient

population included in the audit will be tracked using HES data

on heart failure discharge coding.

Readmissions, including readmissions of the same patient in one

month, count towards the monthly total of cases submitted.

3.3 Ensuring representativeness

Because the National Heart Failure Audit does not require you

to enter all of the heart failure patients discharged from your

hospital, it is essential that the patient sample entered into

the audit is representative of your overall heart failure patient

population. The most effective way of ensuring this is to enter

all heart failure patients into the database, but in the event that

this is not possible patients included in the audit should be

randomly selected (for example, the first 20 heart failure patients

discharged each month) to avoid selection bias.

2 For more information on ICD-10 codes, see http://apps.who.int/classifications/icd10/browse/2010/en#/IX.

3.4 Patient confidentiality and identification

The National Heart Failure Audit collects patient identifiable data

in order to track life status by linkage with MRIS mortality data,

and to enable linkage with the other cardiac databases, such

as MINAP (Myocardial Ischaemia National Audit Project) and

CRM (Cardiac Rhythm Management). However, there are strict

rules for the use of potential patient identifiers; although patient

identifiers are entered into the National Heart Failure Audit, these

can only be seen by staff at your own hospital with access to

the database, and by specific NICOR staff who manage the

database.

When datasets are released to third parties for secondary

research purposes, the following safeguards are in place to

protect patient identity:

�� Patient name is not released for research purposes.

�� NHS number and hospital number (patient case record

number) are pseudonymised. This is done using an encryption

key that the third party using the data does not have access

to, which means that they cannot convert the details back to

their original, identifiable form.

�� Date of birth is converted to age at admission.

�� Postcode can be an identifier where small numbers of

individuals share a post code in rural areas. Postcode is

used to derive dependant variables such as Index of Multiple

Deprivation (England only), and only these derived fields are

available for secondary use.

�� Hospital identifier is also pseudonymised, so that third parties

outside of NICOR cannot undertake identifiable hospital-

specific analysis.

3.5 Patient consent

NICOR has section 251 approval from the NIGB, which allows

it to collect and process patient identifiable data for all of the

cardiovascular audits, including the National Heart Failure Audit,

without requiring consent. However we recommend that you tell

patients that their anonymised data will be used for national audit

and research purposes to improve patient care.

A patient leaflet, along with more information about NICOR, is

available on the NICOR website.3

3 http://www.ucl.ac.uk/nicor/audits.

http://apps.who.int/classifications/icd10/browse/2010/en#/IX

http://apps.who.int/classifications/icd10/browse/2010/en#/IX

http://www.ucl.ac.uk/nicor/audits

Data collection


3.6 Using the data application and submitting data

Help notes on using the Lotus Notes data application can be found

on the NICOR website,4 or in the “Audit Information” section of the

left hand navigator in the database. These manuals also include

information on importing records from existing local databases.

A pro forma to facilitate data collection, the core dataset and

the full dataset are reproduced in this document (§7, 8, 9). The

dataset and pro forma can also be downloaded from the NICOR

website.5

You can export the data that you submit to the audit to Excel in

order to analyse clinical practice and check data quality. This is

done by using the Export option under Import/Export in the Lotus

Notes left navigator panel. You can choose to export the core or

full dataset, and can limit your export by year or by date range.

Please note that admissions and readmissions are exported

separately.

3.7 Use of National Heart Failure Audit data

Participation in the National Heart Failure Audit has been

mandated by the NHS standard contracts for acute hospital

services.6 Audit data are used by increasing numbers of groups

outside of your hospital which have a legitimate interest in the

analysis. These include:

Indicators for quality improvement: The NHS Information

Centre and the Department of Health have identified an initial, but

evolving, set of ‘Indicators for Quality Improvement’ to describe

the quality of a broad range of healthcare services.7

These indicators include participation in the Heart Failure Audit,

which is defined as a Trust submitting 20 patient admissions per

month to the National Heart Failure Audit between 01/04/2010

and 31/03/2011.8

The NHS Choices website also includes details of participation in

the audit in its ‘scorecard’ for Trust performance.

Care Quality Commission Quality Risk profiles:9 The QRP is

a tool used for gathering together key information about your

organisation to support how the CQC monitor your compliance

with the essential standards of quality and safety. The QRP

enables compliance inspectors to assess where risks lie and may

prompt front line regulatory activity, such as further enquiries.

Initially participation rates will be provided to CQC but they are

keen to use further data in future.

Transparency agenda: Clinical audit was one of six key areas

raised under the heading ‘NHS’ in the Prime Minister’s Letter to

Cabinet Ministers on transparency and open data which stated:

4 www.ucl.ac.uk/nicor/audits/heartfailure/datacollection.5 www.ucl.ac.uk/nicor/audits/heartfailure/dataset.6 See clause 35: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/

documents/digitalasset/dh_131998.pdf.7 http://www.ic.nhs.uk/services/measuring-for-quality-improvement. 8 https://mqi.ic.nhs.uk/Search.aspx?query=heart%25failure&ref=1.05.27.9 http://www.cqc.org.uk/organisations-we-regulate/registered-services/quality-and-risk-

profiles-qrps.

‘Clinical audit data, detailing the performance of publicly

funded clinical teams in treating key healthcare conditions, will

be published from April 2012. This service will be piloted in

December 2011 using data from the latest National Lung Cancer

Audit, commissioned by the Healthcare Quality Improvement

Partnership (HQIP) as part of the National Clinical Audit and

Patient Outcomes Programme (NCAPOP)’.10

National Heart Failure Audit data will be published on data.gov.uk

following the publication of the 2011/12 annual report in October

2012.

There are future plans to provide heart failure data, by hospital,

to Cardiac Networks and commissioners. National Heart Failure

Audit annual reports, containing national aggregate data, are also

available for download on NICOR’s publicly accessible website.

3.8 Ensuring data quality

National Heart Failure Audit data is used for performance

monitoring and management purposes, so it is essential that the

data you submit to the audit is accurate and representative of

the heart failure patients in your hospital. The NICOR heart failure

data application has a number of validation checks built into it

to ensure that the data entered is not contradictory and is within

permitted ranges, but those responsible for entering data need to

monitor the quality of their data entry on top of this. Hospitals are

bound by the Data Protection Act 1998 to ensure that the data

should meet the necessary standards of completeness, accuracy

and relevance.

You should register the National Heart Failure Audit with your

Trust data protection officer, and identify someone in your

hospital with overall responsibility for the audit. One person

should be given overall responsibility for data collection, with

additional clinical support if needed. Backup support must be

identified for periods of leave; it is the responsibility of your Trust

to support you in this.

Current data collection manuals with definitions should be made

available to all staff involved in data collection and entry, and data

should ideally be entered as soon as possible after the patient

has been discharged to ensure the greatest possible accuracy.

You should establish systems to routinely check case inclusion/

exclusion and to monitor the accuracy of discharge coding in

your institution.

3.9 Reporting timescale

The audit year runs from 1st April to 31st March. Unless

otherwise stated, all data for the financial year must be uploaded

to the database by 31st May. Data will be exported for analysis

on 1st June, and no data submitted after this point will be

included in the audit report.

10 http://www.number10.gov.uk/news/letter-to-cabinet-ministers-on-transparency-and-open-data/.

http://www.ucl.ac.uk/nicor/audits/heartfailure/datacollection

http://www.ucl.ac.uk/nicor/audits/heartfailure/dataset

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131998.pdf

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131998.pdf

http://www.ic.nhs.uk/services/measuring-for-quality-improvement

https://mqi.ic.nhs.uk/Search.aspx?query=heart%25failure&ref=1.05.27

http://www.cqc.org.uk/organisations-we-regulate/registered-services/quality-and-risk-profiles-qrps

http://www.cqc.org.uk/organisations-we-regulate/registered-services/quality-and-risk-profiles-qrps

http://www.number10.gov.uk/news/letter-to-cabinet-ministers-on-transparency-and-open-data/

http://www.number10.gov.uk/news/letter-to-cabinet-ministers-on-transparency-and-open-data/

The dataset


4 The datasetThe National Heart Failure Audit database now contains over

125,000 records of patients discharged from hospital with a

diagnosis of heart failure. This large amount of data can be used

to monitor trends in the management of heart failure patients and

to determine key clinical indictors for heart failure patients.

The core dataset, on which all reporting is based, has been

revised and now contains 59 items. The new data items and

changes to the existing core dataset have been added following

the publication of clinical guidelines for chronic heart failure

(2010) and a quality standard for chronic heart failure (2011)

by NICE.11 The dataset now allows the audit to collect data to

analyse the implementation of nationally recognised clinical

indicators for the optimum treatment and management of heart

failure patients. Section 6 of this document justifies the items in

the core dataset by mapping them onto the NICE standards and

explaining why the audit collects each data item.

With the audit now collecting a substantial amount of data each

year, it will be possible to analyse outcome data at the level of

individual Trusts, in addition to national, aggregate analyses. In

order to do this, it is necessary to risk adjust the data for known

confounders – certain factors, such as age, index of multiple

deprivation and medical history, have a large impact on morbidity

and mortality outcomes for heart failure patients Several fields

have been added to allow the audit to create risk adjustment

models, which will facilitate the publication of mortality and

morbidity data at regional, Trust and hospital levels.

11 NICE (2010), Clinical guidelines CG108 Chronic heart failure: management of chronic heart failure in adults in primary and secondary care, http://guidance.nice.org.uk/CG108.

NICE (2011), Chronic heart failure quality standard, http://www.nice.org.uk/guidance/qualitystandards/chronicheartfailure/home.jsp.

47 of the 59 fields are now mandatory, i.e. data items that must

be filled in for the record to be saved. Most mandatory fields

(apart from basic patient data) have an ‘unknown’ option, so if

you are unable to obtain some data items the record can still

be saved. Those core items that are not mandatory are mainly

numerical fields (referring to the results of blood tests and

physical examinations, for example), and therefore there is no

possibility for an unknown option. Hospitals are nonetheless

expected to fill in these fields, but they should be left blank if the

value in question was not measured, or if it is not known.

4.1 The data application

In order to accommodate the new fields, the National Heart

Failure Audit data application has been modified. The updated

NICOR application will be available to you automatically on the

NICOR servers. Hospitals using commercial applications or

locally developed applications to import data stored on local

databases must ensure that these are updated to include all of

the modifications in the revised dataset. Commercial software

companies have been notified of the changes, but check with

your provider if in doubt. If your software is locally developed,

you will need to update the locally held options dictionary.

A full dataset is available for download from the National Heart

Failure Audit website.12 The dataset contains information on

the import format to be used when uploading data to the audit

database from commercial or locally developed databases.

A pro forma, to assist in the collection of data, can also be

downloaded from the NICOR website, and can be found in §7 of

this document.

12 www.ucl.ac.uk/nicor/audits/heartfailure/dataset

http://guidance.nice.org.uk/CG108

http://www.nice.org.uk/guidance/qualitystandards/chronicheartfailure/home.jsp

http://www.nice.org.uk/guidance/qualitystandards/chronicheartfailure/home.jsp


The dataset


4.2 New core fields

The following data items are non-core fields in version 2 of the dataset, which are being changed to core fields in version 3. (M) denotes a

mandatory field.

# Field description Short code Long code Field Type

4.07 Previous device therapy

(M)

0 0. None Text (single value)

1 1. CRT-D Text (single value)

2 2. CRT-P Text (single value)

3 3. ICD Text (single value)

4 4. PM Text (single value)

12 12. Declined by patient Text (single value)

4.17 Previous COPD(M) 0 0. No Text (single value)

1 1. Yes Text (single value)

9 9. Unknown Text (single value)

8.01 Height Height (cm) Numeric (real)

8.02 Weight Weight (Kg) Numeric (real)

8.04 Heart rate Heart rate (bmp) Numeric (integer)

8.06 Blood pressure - systolic Blood pressure - systolic (mmHg) Numeric (integer)

9.01 Hb Full blood count Hb (g/dL) Numeric (real)

9.02 Urea Full blood count urea (mg/dL) Numeric (real)

9.03 Creatinine Full blood count creatinine (mmol/L) Numeric (integer)

9.04 Electrolytes: Sodium (Na) Electrolytes-NA (mEq/L) Numeric (integer)

9.05 Electrolytes: Potassium (K) Electrolytes-K (mEd/L) Numeric (real)

9.16 QRS duration QRS Duration (ms) Numeric (integer)

15.01 Cardiac rehabilitation (M) 0 0. No Text (single value)


8 8. Not applicable Text (single value)



15.11 Discharge planning (M)

NB: 15.11 was previously

a multivalue text field, and

is now a single value text

field.

1 1. A heart failure pre-discharge management plan is in

place

Text (single value)

2 2. A heart-failure management plan has been discussed

with the patient

Text (single value)

3 3. A heart failure management plan has been

communicated to the primary care team

Text (single value)

4 4. All of the above Text (single value)

5 5. None of the above Text (single value)


The dataset


4.3 New fields

The following data items are entirely new fields in version 3 of the dataset. (M) denotes a mandatory field.


2.04a Did the patient

receive input from a

multidisciplinary HF team?

(M)

0 0. No Text (single value)



2.04ai Which of the following did

the patient see? (M)

1 1. Consultant cardiologist Text (multivalue;

separated)

2 2. Other consultant with interest in HF Text (multivalue;

separated)

3 3. HF Specialist nurse Text (multivalue;

separated)

4 4. Other Text (multivalue;

separated)

9 9. Unknown Text (multivalue;

separated)

4.14a Previous Asthma (M) 0 0. No Text (single value)



7.40 Ivabradine (non-core) 0 0. No Text (single value)



7.41 Ivabradine dose (non-core) Ivabradine dose Numeric (real)

11.40 Treatment ivabradine (non-

core)




11.41 Treatment ivabradine dose

(non-core)

Treatment ivabradine dose Numeric (real)

15.12 Was a review appointment

with the specialist

multidisciplinary HF team

made? (M)




15.13 Date of HF review

appointment

Date of review appointment Date (dd/mm/yyyy)

15.14 Was the patient stable

on oral therapy after

discharge planning? (M)




15.15 Patient died? (M) 0 0. No Text (single value)


The dataset


4.4 New options within fields

The following data items are additional options added to existing mandatory fields.


11.01 Treatment ACE inhibitor 11 11. Contraindicated Text (single value)


11.04 Treatment ARB 11 11. Contraindicated Text (single value)


11.06 Treatment beta blocker 11 11. Contraindicated Text (single value)


11.09 Treatment loop diuretic 5 5. Other loop diuretic Text (single value)

11 11. Contraindicated Text (single value)


11.11 Treatment thiazide diuretic 8 8. Not applicable Text (single value)



11.13 Treatment ARA 3 3. Other ARA Text (single value)



11.20 Treatment digoxin 8 8. Not applicable Text (single value)



15.01 Cardiac rehabilitation 8 8. Not applicable Text (single value)


15.05 Palliative care 8 8. Not applicable Text (single value)

4.5 Deleted fields


8.12 Peripheral Oedema 0 0. No Text (single value)



Core dataset definitions


5 Core dataset definitionsThe core dataset contains 59 fields, 47 of which are mandatory,

i.e. the record will not be saved without them. If you cannot find

the relevant information needed to satisfy mandatory core data

items in the patient’s notes, you should use the “Unknown”

option.

In the list below, † denotes non-mandatory, core fields. Although

you can save a record without these fields, you are encouraged

to collect and enter the data for them. They are no less important

for clinical monitoring purposes than mandatory core fields, and

their non-mandatory status is on the whole due to technical

features of the database, rather than clinical subordinacy. If

the patient died in hospital, the fields relating to treatment on

discharge and referral to follow-up services are not mandatory.

See §8 for a list of all of the field options for core dataset items,

and §9 for the full dataset. The full dataset, which contains 242

fields, is optional and intended for local use only.

There are five types of record in the National Heart Failure Audit

database: Patient Record, Admission, Readmission, Unscheduled

Event and Life Status.

5.1 Patient record

When entering a patient’s first admission into the database you

will first need to create a patient record, which contains personal

and demographic details.

Hospital identifier (1.01) The three-letter code that identifies

your hospital site. Your hospital code should default from your

user ID.

Local patient identifier (1.02) A hospital number is used to

identify patients if the NHS number is not known. Local patient

identifiers are also used to identify multiple entries and to

categorise readmissions within the same hospital. Readmissions

are a key outcome measure and used as an indicator of the

quality of follow-up care.

NHS number (1.03)† The patient’s NHS number is the unique

national identifier that will be used for event and mortality

tracking. The NHS number also allows patients to be tracked

across the other cardiac audits. The ten-digit number should be

entered with no spaces. There is an algorithm in the Lotus Notes

software to check the validity of the NHS number.

Although the NHS number is not a mandatory field, it is important

for accurate mortality tracking and data linkage that as many

patients as possible have their NHS number entered accurately.

Patient name (surname) (1.04) The patient’s name is used for

mortality tracking in the instance that there is a discrepancy

between any of the other patient identifiers, or if the NHS number

is missing.

Patient name (forename) (1.05)

Birth date (1.06) Date of birth is crucial for verifying mortality

data and identifying missing NHS numbers. It is also used for risk

adjustment and to measure potential inequalities in access to care,

and to monitor changes in patient demographics.

A patient must be over 16 years of age to be entered into the

heart failure database. Date of birth should be in the format dd/

mm/yyyy.

Patient gender (1.07) Patient gender is used to measure

potential inequalities in access to care, and to monitor changes in

patient demographics.

Postcode (1.09) This is the postcode nominated by the patient

as their main permanent residence. Pseudo postcodes should

be used for foreign nationals; a list of pseudo postcodes can be

found in the NHS Postcode Directory.13

The postcode is used for local morbidity/mortality analysis, and is

also used to calculate the patient’s index of multiple deprivation.

5.2 Admission/readmission

Once you have created a patient record you can add an

admission and subsequently multiple readmissions for the

patient. A readmission can only be created if there is already an

admission for that patient.

If you are entering data via the Lotus Notes application the core

fields are divided into the following sub-headings: Admission

and Symptoms, History, Physical Examination, Investigations,

Treatment on Discharge, Diagnosis, Discharge, and User Defined

Fields.

5.2.1 Admission and symptoms

Date of admission (2.00) The date on which the patient was

admitted to hospital. This is used to calculate the length of stay,

and to measure year-on-year improvements in care. Date should

be in the format dd/mm/yyyy.

Breathlessness (3.01) This is a standard breathlessness score

using the New York Heart Association (NYHA) Classification.

Breathlessness should be measured on admission.

1. No limitation of physical activity: Ordinary physical activity

does not cause fatigue, breathlessness or palpitation (NYHA

Class I).

2. Slight limitation of ordinary physical activity: Patients are

comfortable at rest. Ordinary physical activity results in

fatigue, palpitation, breathlessness or angina pectoris (NYHA

Class II).

3. Marked limitation of ordinary physical activity: Although

patients are comfortable at rest, less than ordinary activity will

lead to symptoms (NYHA Class III).

13 http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/.

http://nww.connectingforhealth.nhs.uk/nacs/downloads/officenatstats/



4. Symptoms at rest or minimal activity: Symptoms of congestive

cardiac failure are present even at rest. Increased discomfort

with any physical activity (NYHA Class IV).

5.2.2 History

Previous IHD (4.00) Does the patient have history of myocardial

infarction (MI), angina, ECG evidence of MI, CABG or angiogram

documenting coronary artery disease?

Previous AMI (4.01) Has the patient had a previously validated

episode of acute myocardial infarction (MI), including ECG

evidence of MI (for example Q-waves on admission)?

Previous valve disease (4.09) Does the patient have a history of

clinically diagnosed valve disease, moderate or severe stenosis

or regurgitation on imaging, or an operative valve replacement/

repair?

Previous hypertension (4.12) Is the patient already receiving

treatment (drug, dietary or lifestyle) for hypertension or have they

had a recorded blood pressure >140/90 mmHg on at least two

occasions prior to admission?

Previous diabetes (4.14) Has the patient been diagnosed

with diabetes prior to admission? This could include any

of: a confirmed diagnosis of diabetes, the use of an oral

hypoglycaemic agent or insulin, a fasting blood glucose >6.7, or

a random blood glucose >11 mmol/L.

Previous asthma (4.14a) Does the patient have a history of

asthma? This can be a previous clinical diagnosis or known

significant reversible airways obstruction.

Previous COPD (4.17) Does the patient have a history of COPD

(chronic obstructive pulmonary disease), including chronic

bronchitis, emphysema or their co-occurrence? Must be

indicated by pulmonary function testing evidence i.e. FEV1<75%

predicted value or use of beta agonist/steroid inhalers.

5.2.3 Physical examination

Peripheral Oedema (3.04) Did the patient exhibit ankle or sacral

oedema on admission?

0. No

1. Mild: Pitting oedema to the ankle.

2. Moderate: Oedema between ankle and knee.

3. Severe: Oedema above the knee.

4. Unknown: Information about oedema is not available – e.g. not

recorded in notes.

Height (8.01)† Height in centimetres (last available recording).

Weight (8.02)† Weight in kilograms (last available recording).

Heart rate (8.04)† Heart rate, measured in bpm (last available

recording).

Blood pressure – systolic (8.06)† The systolic blood pressure of

the patient (last available recording).

NB. Height, weight, heart rate and systolic blood pressure are not

mandatory fields, but are important for risk adjusting mortality

and for morbidity analysis. Height and weight are used to

calculate patient BMI.

5.2.4 Investigations

For all investigations, if multiple tests were performed the results

of the last test should be recorded. For all blood tests and QRS

duration, leave blank if test was not done or the result is not

known.

Hb (9.01)† A record of the patient’s haemoglobin level in grams

per decilitre (g/dL).

Urea (9.02)† A record of the patient’s urea level in milligrams per

decilitre (mg/dL).

Creatinine (9.03)† A record of the patient’s creatinine level in

micromoles per litre (μmol/L).

Electrolytes: Sodium (Na) (9.04)† A record of the patient’s

sodium level in milliequivalents per litre (mEq/L).

Electrolytes: Potassium (K) (9.05)† A record of the patient’s

potassium level in milliequivalents per litre (mEq/L).

NB: The above blood tests are not mandatory fields, but these

measurements are a NICE recommended diagnostic tool for heart

failure, so it is recommended that these tests are both performed

and subsequently recorded in the audit.

BNP (9.13)† A record of the patient’s B-type Natriuretic Peptide

(BNP) level in picograms per millilitre (pg/mL).

BNP is not a mandatory field, but the measurement of BNP

is a NICE quality standard for chronic heart failure, so it is

recommended that BNP level is measured and recorded in the

audit.

QRS Duration (9.16)† The QRS duration in milliseconds (ms), if

known. QRS Duration is not a mandatory field, but if an ECG was

performed then QRS duration should be known.

ECG (9.21) Was an electrocardiogram was performed during this

admission, and if so, what did it show? If not done, has an ECG

been planned? ECG is recommended as a diagnostic test in the

NICE quality standard for chronic heart failure.

1. Sinus rhythm: An electrocardiogram was performed, and

heart rhythm was normal.

2. Atrial fibrillation: An electrocardiogram was performed

showing atrial fibrillation.

3. LBBB: An electrocardiogram was performed showing left

bundle branch block.

4. Previous MI: An electrocardiogram was performed showing

previous myocardial infarction.

6. Not done – planned after discharge: An electrocardiogram

has been planned post discharge but not yet undertaken.

7. Not done – not yet planned: An electrocardiogram has not

been not undertaken, and has not yet been ordered.

8. Other: An electrocardiogram was performed showing a



rhythm not listed above OR an electrocardiogram was

performed but information about heart rhythm is unknown.

9. Unknown: Information about electrocardiography is not

available – e.g. not recorded in notes.

Multiple options can be selected but note that 6, 7, and 9 cannot

be selected in combination with any other values.

ECHO (9.23) Did the patient receive a gold standard diagnostic

test? This could include ECHO, MRI, Nuclear scan, angiogram,

CT scan etc. If so, what diagnosis was given? If the patients had

a gold standard test on a previous admission or outpatient visit,

options 0 to 4 are still valid. If not done, has a test been planned?

0. Normal: A gold standard test was undertaken, and heart

function was normal.

1. LV systolic dysfunction: Moderate or severe left ventricular

systolic dysfunction (for example, a left ventricular ejection

fraction (LVEF) <40% or eyeball method of assessment).

2. LV hypertrophy: Moderate or severe left ventricular

hypertrophy reported on an imaging test (for example, LV

posterior wall dimension in diastole >1.3cm and/or septal

dimension >1.3cm).

3. Valve disease: Moderate or severe stenosis or regurgitation on

imaging, or an operative valve replacement/repair. Prosthetic

valves do not need to be included here.

4. Diastolic dysfunction: A gold standard test was undertaken

and showed diastolic dysfunction.

6. Test not done – planned after discharge: A gold standard

diagnostic test has been planned post discharge but not yet

undertaken

7. Test not done – not yet planned: A gold standard diagnostic

test was not undertaken, and has not yet been ordered.

8. Other: A gold standard test was undertaken, and some other

diagnosis was given.

9. Unknown: Information about the performance of a gold

standard test, or its outcome, is not available – e.g. not

recorded in notes.

Multiple options can be selected but note that 0, 6, 7, and 9

cannot be selected in combination with any other values.

5.2.5 Treatment on discharge

If a patient died in hospital, fields relating to their treatment on

discharge are no longer mandatory.14 Treatment dosages are not

mandatory, but clinical outcomes are associated with titration

levels, so if the dose is known you are encouraged to enter it.

Dose refers to total daily dose.

For all treatment on discharge fields:

8. Not applicable: The use of the treatment was not indicated

in this case, e.g. the treatment was not clinically appropriate,

the patient did not have heart failure.

14 Dataset items 11.01, 11.04, 11.06, 11.09, 11.11, 11.13, 11.20.

9. Unknown: Information about the prescription of the treatment

is not available – e.g. not recorded in notes.

10. Drug therapy stopped: The treatment was prescribed but

was stopped before discharge.

11. Contraindicated: The treatment was contraindicated in this

case, or the patient was intolerant.

12. Declined by patient: The treatment was offered, but was

declined by the patient.

Treatment ACE inhibitor (11.01) Was the patient prescribed

angiotensin converting enzyme (ACE) inhibitors on discharge?

1. Captopril

2. Enalpril

3. Lisinopril

4. Perindopril

5. Ramipril

6. Trandolapril

7. Other ACEI

Treatment ARB (11.04) Was the patient prescribed angiotensin

receptor blockers (ARBs) on discharge?

1. Candesartan

2. Losartan

3. Valsartan

4. Other ARB

Treatment beta blocker (11.06) Was the patient prescribed beta

blockers on discharge?

1. Bisoprolol

2. Carvedilol

3. Nebivolol

4. Other beta blocker

Treatment loop diuretic (11.09) Was the patient prescribed loop

diuretics on discharge?

1. Bumetanide

2. Ethancrynic acid

3. Furosemide

4. Torasemide

5. Other loop diuretic

Treatment thiazide diuretic (11.11) Was the patient prescribed

thiazide diuretics on discharge?

1. Bendroflumethazide

2. Metolazone

3. Other thiazide

Treatment ARA (11.13) Was the patient prescribed aldosterone

receptor antagonists (ARAs) on discharge?



1. Eplerenone

2. Spironolactone

3. Other ARA

Previous device therapy (4.07) Has the patient had device

therapy either during this admission or at a previous time?

1. CRT-D: The patient has been referred for a cardiac

resynchronisation therapy (CRT) defibrillator.

2. CRT-P: The patient has been referred for a CRT pacemaker.

3. ICD: the patient has been referred for an implantable

cardioverter defibrillator.

4. PM: the patient has been referred for a pacemaker.

5.2.6 Diagnosis

Diagnosis of heart failure (14.00) Was the patient diagnosed

with heart failure on this or a previous admission?

0. No: A diagnosis of heart failure was excluded by a cardiologist

on the basis of imaging or BNP level or

1. Yes: The diagnosis of heart failure has been confirmed by

imaging or BNP testing either during this admission or at

a previous time. In some cases a clinician may justifiably

diagnose heart failure in the absence of echocardiography.

9. Unknown: No information about imaging or BNP is available

to support a diagnosis of heart failure – e.g. not recorded in

notes.

5.2.7 Discharge

Some fields referring to discharge instructions and follow-up

services are not mandatory if the patient died in hospital.15

Main place of care (2.04) In your opinion, the ward in which

the patient received the majority of their care. “3. Other” will in

many cases be a geriatrics ward. Being admitted to a cardiology

ward is a key determinant of good care and treatment for patient,

which results in reduced morbidity and mortality rates.

Did the patient receive input from a multidisciplinary HF

team? (2.04a) Did the patient receive input from any member of

the multidisciplinary heart failure team during this admission?

A multidisciplinary heart failure team is led by a specialist and

consists of professionals with appropriate competencies from

primary and secondary care. The term ‘specialist’ denotes a

physician with subspecialty interest in heart failure (often a

consultant cardiologist). The team may involve other services

(such as rehabilitation, tertiary care and palliative care) in the care

of individual patients.16

The input of a multidisciplinary heart failure team is

recommended by NICE quality standard for chronic heart failure.

Which of the following did the patient see? (2.04ai) Which

15 Dataset items 15.00, 15.01, 15.05, 15.06, 15.07, 15.08, 15.11, 15.12, 15.14.16 This definition of a multidisciplinary heart failure team is taken from NICE (2010), Clinical

guidelines CG108 Chronic heart failure: management of chronic heart failure in adults in primary and secondary care, http://guidance.nice.org.uk/CG108.

clinical staff and specialists saw the patient during their

admission? NICE quality standard for chronic heart failure

recommends that patients see specialist heart failure/cardiology

staff. Treatment by specialists is a key clinical indicator for heart

failure patients.

1. Consultant cardiologist

2. Other consultant with interest in heart failure: This may be a

care of the elderly physician or a non-cardiologist consultant

with a specified responsibility for heart failure patients within

the hospital.

3. Heart failure specialist nurse: A heart failure specialist nurse is

a nurse with specific remit for the care of heart failure patients

in hospital or the community.

4. Other: This could be a general medical consultant or other

speciality consultant within the hospital.

9. Unknown

Multiple options can be selected but note that 9 cannot be

selected in combination with any other values.

HF liaison service (15.00) Has the patient been referred to a

heart failure specialist nurse for follow-up? This can be in the

community or in hospital.

The NICE quality standard for chronic heart failure recommends

that heart failure patients should receive a clinical assessment

by a multidisciplinary team within two weeks of discharge, and a

clinical assessment at least every six months after that.

Cardiac rehabilitation (15.01) Was the patient referred to a

cardiac rehabilitation programme? Cardiac rehab usually involves

an exercise-based programme that includes educational and

psychological support, but can occur without an exercise

component if the patient cannot tolerate exercise.

The NICE quality standard for chronic heart failure recommends

that people with stable chronic heart failure and no precluding

condition or device are offered a supervised group exercise-

based cardiac rehabilitation programme that includes education

and psychological support.

Palliative care (15.05) Were the palliative care services involved

or planned for on discharge?

COTE/medical follow up (15.06) Was the patient referred to

follow-up in a geriatric or general medical ward, or were care of

the elderly (COTE) services involved or planned for on discharge?

Cardiology follow up (15.07) Was the patient referred for follow-

up by a consultant cardiologist?

GP (15.08) Was the patient discharged to the care of their GP?

Date of discharge (15.10) The date on which the patient was

discharged, transferred to another hospital, or the date of death

if patient died in hospital. Date should be in the format dd/mm/

yyyy.

This is required to measure length of stay which is a key patient

outcome for the audit.



Discharge planning (15.11)

The discharge plan may cover discussion of discharge medication

and future up-titration of treatment, follow-up appointments,

management of heart failure, dietary and lifestyle advice, weight

management and exercise. Discharge planning may include

discussion of the stability of the patient’s clinical condition, and

may take into account patient and carer wishes, and the level of

care and support that can be provided in the community.

NICE quality standard for chronic heart failure recommends

that people admitted to hospital because of heart failure have a

personalised management plan that is shared with them, their

carer(s) and their GP.

1. A heart failure pre-discharge management plan is in place

2. A heart-failure management plan has been discussed with the

patient

3. A heart failure management plan has been communicated to

the primary care team

4. All of the above

5. None of the above

9. Unknown

Was a review appointment with the specialist

multidisciplinary HF team made? (15.12) Was an appointment

with any member of the multidisciplinary heart failure team made

for the patient on discharge?

A multidisciplinary heart failure team is led by a specialist and

consists of professionals with appropriate competencies from

primary and secondary care. The term ‘specialist’ denotes a

physician with subspecialty interest in heart failure (often a

consultant cardiologist). The team may involve other services

(such as rehabilitation, tertiary care and palliative care) in the care

of individual patients.

NICE quality standard for chronic heart failure recommends that

heart failure patients should receive a clinical assessment by a

multidisciplinary team within two weeks of discharge.

Date of heart failure review appointment (15.13)† Leave blank

if the date of this appointment is not yet known. Date should be

in the format dd/mm/yyyy.

Was the patient stable on oral therapy after discharge

planning? (15.14) Was the patient established on oral medication

for at least 48 hours without further decompensation of heart

failure and with stable renal function?

Did the patient die? (15.15) Did the patient die during this

admission? If the patient died, fields referring to follow-up care

and treatment on discharge are not mandatory.

5.2.8 User defined fields

For local audit purposes, data can be collected on fields not

included in the audit. The full dataset has 242 items, so much of

the data relevant to heart failure patients can be collected using

existing fields.

You can add user defined fields by going to the “Settings” link in

the left navigator of Lotus Notes. Choose “Hospitals”, find your

hospital and double click it. Select the “User Defined Fields” tab

and double click next to “Field 1” to add a new field description.

These descriptions will now appear as free text fields in the “User

Defined Fields” section of each admission and readmission you

create.

Note that user defined fields can only be used if data is uploaded

via Lotus Notes, and cannot be included in imported comma

separated value files.

5.3 Unscheduled event

An unscheduled event record can be created in order to record

major events in a patient’s medical history, including death

in hospital, in-patient admissions to hospital for heart failure,

other cardiovascular and non-cardiovascular conditions, and

unscheduled out-patient hospital visits.

This is for local use only – for audit analyses, life status and

readmission to hospital will be ascertained by linking data from

the National Heart Failure Audit database with MRIS mortality

tracking and HES discharge coding data.

Event date (16.01)

Event (16.02)

5.4 Life status

A life status record can be created to indicate whether the

patient is alive or dead at a given date. This is for local use only

– for audit purposes life status is obtained from MRIS mortality

tracking.

Life status date (17.01)

Life status (17.02)

Clinical guidelines


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Pre

viou

s A

MI

4.09

Pre

viou

s va

lve

dis

ease

4.12

Pre

viou

s hy

per

tens

ion

4.14

Pre

viou

s d

iab

etes

4.14

aP

revi

ous

asth

ma

4.17

Pre

viou

s C

OP

D

8.01

Hei

ght

Nee

ded

to

calc

ulat

e B

MI,

whi

ch is

req

uire

d fo

r d

evel

opin

g ris

k ad

just

ed d

ata

e.g.

mor

talit

y.8.

02W

eigh

t

8.04

Hea

rt r

ate

Req

uire

d fo

r d

evel

opin

g ris

k ad

just

ed d

ata

e.g.

mor

talit

y.8.

06B

lood

pre

ssur

e -

syst

olic

9.01

Hb

Req

uire

d fo

r d

evel

opin

g ris

k ad

just

ed d

ata

e.g.

mor

talit

y.

NIC

E C

G10

8, 1

.1.1

.13:

Con

sid

er t

he fo

llow

ing

[blo

od] t

ests

to

eval

uate

pos

sib

le a

ggra

vatin

g fa

ctor

s an

d/o

r al

tern

ativ

e

dia

gnos

es:

��

elec

trol

ytes

, ure

a an

d c

reat

inin

e

��

full

blo

od c

ount

9.02

Ure

a

9.03

Cre

atin

ine

9.04

Ele

ctro

lyte

s: S

odiu

m (N

a)

9.05

Ele

ctro

lyte

s: P

otas

sium

(K)

9.13

BN

PN

ICE

CG

108,

1.1

.1.3

: Mea

sure

ser

um n

atriu

retic

pep

tides

(B-t

ype

natr

iure

tic p

eptid

e [B

NP

] or

N-t

erm

inal

pro

-B-t

ype

natr

iure

tic

pep

tide

[NTp

roB

NP

]) in

pat

ient

s w

ith s

usp

ecte

d h

eart

failu

re w

ithou

t p

revi

ous

MI.

NIC

E q

ualit

y st

and

ard

2: P

eop

le p

rese

ntin

g in

prim

ary

care

with

sus

pec

ted

hea

rt fa

ilure

with

out

pre

viou

s m

yoca

rdia

l inf

arct

ion

have

the

ir se

rum

nat

riure

tic p

eptid

es m

easu

red

.

9.16

QR

S D

urat

ion

9.21

EC

GN

ICE

CG

108,

1.1

.1.1

3: P

erfo

rm a

n E

CG

…to

eva

luat

e p

ossi

ble

agg

rava

ting

fact

ors

and

/or

alte

rnat

ive

dia

gnos

es.

Clinical guidelines


Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nJu

stifi

cati

on

9.23

EC

HO

(or

othe

r go

ld s

tand

ard

tes

t e.

g. M

RI,

Nuc

lear

Sca

n or

Ang

iogr

am)

NIC

E C

G10

8, 1

.1.1

.2: R

efer

pat

ient

s w

ith s

usp

ecte

d h

eart

failu

re a

nd p

revi

ous

myo

card

ial i

nfar

ctio

n (M

I) ur

gent

ly, t

o ha

ve

tran

stho

raci

c D

opp

ler

2D e

choc

ard

iogr

aphy

and

sp

ecia

list

asse

ssm

ent

with

in 2

wee

ks.

NIC

E C

G10

8, 1

.1.1

.4: B

ecau

se v

ery

high

leve

ls o

f ser

um n

atriu

retic

pep

tides

car

ry a

poo

r p

rogn

osis

, ref

er p

atie

nts

with

susp

ecte

d h

eart

failu

re a

nd a

BN

P le

vel a

bov

e 40

0 p

g/m

l (11

6 p

mol

/litr

e) o

r an

NTp

roB

NP

leve

l ab

ove

2000

pg/

ml (

236

pm

ol/

litre

) urg

ently

, to

have

tra

nsth

orac

ic D

opp

ler

2D e

choc

ard

iogr

aphy

and

sp

ecia

list

asse

ssm

ent

with

in 2

wee

ks.

NIC

E C

G10

8, 1

.1.1

.5: R

efer

pat

ient

s w

ith s

usp

ecte

d h

eart

failu

re a

nd a

BN

P le

vel b

etw

een

100

and

400

pg/

ml (

29–1

16 p

mol

/

litre

) or

an N

Tpro

BN

P le

vel b

etw

een

400

and

200

0 p

g/m

l (47

–236

pm

ol/li

tre)

to

have

tra

nsth

orac

ic D

opp

ler

2D e

choc

ard

iogr

aphy

and

sp

ecia

list

asse

ssm

ent

with

in 6

wee

ks.

NIC

E C

G10

8, 1

.1.1

.7: P

erfo

rm t

rans

thor

acic

Dop

ple

r 2D

ech

ocar

dio

grap

hy t

o ex

clud

e im

por

tant

val

ve d

isea

se, a

sses

s th

e

syst

olic

(and

dia

stol

ic) f

unct

ion

of t

he (l

eft)

vent

ricle

, and

det

ect

intr

acar

dia

c sh

unts

.

NIC

E C

G10

8, 1

.1.1

.10:

Con

sid

er a

ltern

ativ

e m

etho

ds

of im

agin

g th

e he

art

(for

exam

ple

, rad

ionu

clid

e an

giog

rap

hy, c

ard

iac

mag

netic

res

onan

ce im

agin

g or

tra

nsoe

sop

hage

al D

opp

ler

2D e

choc

ard

iogr

aphy

) whe

n a

poo

r im

age

is p

rod

uced

by

tran

stho

raci

c D

opp

ler

2D e

choc

ard

iogr

aphy

.

NIC

E q

ualit

y st

and

ard

3: P

eop

le r

efer

red

for

spec

ialis

t as

sess

men

t in

clud

ing

echo

card

iogr

aphy

, eith

er b

ecau

se o

f sus

pec

ted

hear

t fa

ilure

and

pre

viou

s m

yoca

rdia

l inf

arct

ion

or s

usp

ecte

d h

eart

failu

re a

nd h

igh

seru

m n

atriu

retic

pep

tide

leve

ls, a

re s

een

by

a sp

ecia

list

and

hav

e an

ech

ocar

dio

gram

with

in 2

wee

ks o

f ref

erra

l.

NIC

E q

ualit

y st

and

ard

4: P

eop

le r

efer

red

for

spec

ialis

t as

sess

men

t in

clud

ing

echo

card

iogr

aphy

bec

ause

of s

usp

ecte

d h

eart

failu

re a

nd in

term

edia

te s

erum

nat

riure

tic p

eptid

e le

vels

are

see

n b

y a

spec

ialis

t an

d h

ave

an e

choc

ard

iogr

am w

ithin

6 w

eeks

of

refe

rral

.

11.0

1Tr

eatm

ent

AC

E in

hib

itor

NIC

E C

G10

8, 1

.2.2

.2: O

ffer

bot

h an

giot

ensi

n-co

nver

ting

enzy

me

(AC

E) i

nhib

itors

and

bet

a-b

lock

ers

licen

sed

for

hear

t fa

ilure

to a

ll p

atie

nts

with

hea

rt fa

ilure

due

to

left

ven

tric

ular

sys

tolic

dys

func

tion.

Use

clin

ical

jud

gem

ent

whe

n d

ecid

ing

whi

ch d

rug

to

star

t fir

st.

NIC

E q

ualit

y st

and

ard

7: P

eop

le w

ith c

hron

ic h

eart

failu

re d

ue t

o le

ft v

entr

icul

ar s

ysto

lic d

ysfu

nctio

n ar

e of

fere

d a

ngio

tens

in-

conv

ertin

g en

zym

e in

hib

itors

(or

angi

oten

sin

II re

cep

tor

anta

goni

sts

licen

sed

for

hear

t fa

ilure

if t

here

are

into

lera

ble

sid

e ef

fect

s

with

ang

iote

nsin

-con

vert

ing

enzy

me

inhi

bito

rs) a

nd b

eta-

blo

cker

s lic

ense

d fo

r he

art

failu

re, w

hich

are

gra

dua

lly in

crea

sed

up

to

the

optim

al t

oler

ated

or

targ

et d

ose

with

mon

itorin

g af

ter

each

incr

ease

.

11.0

4Tr

eatm

ent

AR

BN

ICE

CG

108,

1.2

.2.4

: See

k sp

ecia

list

advi

ce a

nd c

onsi

der

ad

din

g on

e of

the

follo

win

g if

a p

atie

nt r

emai

ns s

ymp

tom

atic

des

pite

optim

al t

hera

py

with

an

AC

E in

hib

itor

and

a b

eta-

blo

cker

:

an a

ngio

tens

in II

rec

epto

r an

tago

nist

(AR

B) l

icen

sed

for

hear

t fa

ilure

(esp

ecia

lly if

the

pat

ient

has

mild

to

mod

erat

e he

art

failu

re

[NY

HA

cla

ss II

–III]

).

NIC

E C

G10

8, 1

.2.2

.14:

Con

sid

er a

n A

RB

lice

nsed

for

hear

t fa

ilure

as

an a

ltern

ativ

e to

an

AC

E in

hib

itor

for

pat

ient

s w

ith h

eart

failu

re d

ue t

o le

ft v

entr

icul

ar s

ysto

lic d

ysfu

nctio

n w

ho h

ave

into

lera

ble

sid

e ef

fect

s w

ith A

CE

inhi

bito

rs.

NIC

E q

ualit

y st

and

ard

7: P

eop

le w

ith c

hron

ic h

eart

failu

re d

ue t

o le

ft v

entr

icul

ar s

ysto

lic d

ysfu

nctio

n ar

e of

fere

d a

ngio

tens

in-

conv

ertin

g en

zym

e in

hib

itors

(or

angi

oten

sin

II re

cep

tor

anta

goni

sts

licen

sed

for

hear

t fa

ilure

if t

here

are

into

lera

ble

sid

e ef

fect

s

with

ang

iote

nsin

-con

vert

ing

enzy

me

inhi

bito

rs) a

nd b

eta-

blo

cker

s lic

ense

d fo

r he

art

failu

re, w

hich

are

gra

dua

lly in

crea

sed

up

to

the

optim

al t

oler

ated

or

targ

et d

ose

with

mon

itorin

g af

ter

each

incr

ease

.

Clinical guidelines


Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nJu

stifi

cati

on

11.0

6Tr

eatm

ent

bet

a b

lock

erN

ICE

CG

108,

1.2

.2.2

: Offe

r b

oth

angi

oten

sin-

conv

ertin

g en

zym

e (A

CE

) inh

ibito

rs a

nd b

eta-

blo

cker

s lic

ense

d fo

r he

art f

ailu

re to

all

pat

ient

s w

ith h

eart

failu

re d

ue to

left

ven

tric

ular

sys

tolic

dys

func

tion.

Use

clin

ical

jud

gem

ent w

hen

dec

idin

g w

hich

dru

g to

sta

rt fi

rst.

NIC

E C

G10

8, 1

.2.2

.7: O

ffer

bet

a-b

lock

ers

licen

sed

for

hear

t fa

ilure

to

all p

atie

nts

with

hea

rt fa

ilure

due

to

left

ven

tric

ular

sys

tolic

dys

func

tion,

incl

udin

g ol

der

ad

ults

and

pat

ient

s w

ith:

��

per

iphe

ral v

ascu

lar

dis

ease

��

erec

tile

dys

func

tion

��

dia

bet

es m

ellit

us

��

inte

rstit

ial p

ulm

onar

y d

isea

se a

nd

��

chro

nic

obst

ruct

ive

pul

mon

ary

dis

ease

(CO

PD

) with

out

reve

rsib

ility

.

NIC

E q

ualit

y st

and

ard

7: P

eop

le w

ith c

hron

ic h

eart

failu

re d

ue t

o le

ft v

entr

icul

ar s

ysto

lic d

ysfu

nctio

n ar

e of

fere

d a

ngio

tens

in-

conv

ertin

g en

zym

e in

hib

itors

(or

angi

oten

sin

II re

cep

tor

anta

goni

sts

licen

sed

for

hear

t fa

ilure

if t

here

are

into

lera

ble

sid

e ef

fect

s

with

ang

iote

nsin

-con

vert

ing

enzy

me

inhi

bito

rs) a

nd b

eta-

blo

cker

s lic

ense

d fo

r he

art

failu

re, w

hich

are

gra

dua

lly in

crea

sed

up

to

the

optim

al t

oler

ated

or

targ

et d

ose

with

mon

itorin

g af

ter

each

incr

ease

.

11.0

9Tr

eatm

ent

loop

diu

retic

NIC

E C

G10

8, 1

.2.2

.17:

Diu

retic

s sh

ould

be

rout

inel

y us

ed fo

r th

e re

lief o

f con

gest

ive

sym

pto

ms

and

flui

d r

eten

tion

in p

atie

nts

with

hea

rt fa

ilure

, and

titr

ated

(up

and

dow

n) a

ccor

din

g to

nee

d fo

llow

ing

the

initi

atio

n of

sub

seq

uent

hea

rt fa

ilure

the

rap

ies.

11.1

1Tr

eatm

ent

thia

zid

e d

iure

tic

11.1

3Tr

eatm

ent

AR

AN

ICE

CG

108,

1.2

.2.4

: See

k sp

ecia

list

advi

ce a

nd c

onsi

der

ad

din

g on

e of

the

follo

win

g if

a p

atie

nt r

emai

ns s

ymp

tom

atic

des

pite

optim

al t

hera

py

with

an

AC

E in

hib

itor

and

a b

eta-

blo

cker

:

an a

ldos

tero

ne a

ntag

onis

t lic

ense

d fo

r he

art

failu

re (e

spec

ially

if t

he p

atie

nt h

as m

oder

ate

to s

ever

e he

art

failu

re [N

YH

A c

lass

III–I

V] o

r ha

s ha

d a

n M

I with

in t

he p

ast

mon

th).

11.2

0Tr

eatm

ent

dig

oxin

NIC

E C

G10

8, 1

.2.2

.16:

Dig

oxin

is r

ecom

men

ded

for

wor

seni

ng o

r se

vere

hea

rt fa

ilure

due

to

left

ven

tric

ular

sys

tolic

dys

func

tion

des

pite

firs

t- a

nd s

econ

d-l

ine

trea

tmen

t fo

r he

art

failu

re.

12.0

1Tr

eatm

ent

dev

ice

ther

apy

14.0

0D

iagn

osis

of h

eart

failu

reN

ICE

CG

108,

1.1

.2.1

: The

bas

is fo

r hi

stor

ical

dia

gnos

is o

f hea

rt fa

ilure

sho

uld

be

revi

ewed

, and

onl

y p

atie

nts

who

se d

iagn

osis

is

confi

rmed

sho

uld

be

man

aged

in a

ccor

dan

ce w

ith t

his

guid

elin

e.

15.0

0H

F lia

ison

ser

vice

NIC

E q

ualit

y st

and

ard

9: P

eop

le w

ith s

tab

le c

hron

ic h

eart

failu

re r

ecei

ve a

clin

ical

ass

essm

ent

at le

ast

ever

y 6

mon

ths,

incl

udin

g a

revi

ew o

f med

icat

ion

and

mea

sure

men

t of

ren

al fu

nctio

n.

NIC

E q

ualit

y st

and

ard

12:

Peo

ple

ad

mitt

ed t

o ho

spita

l for

hea

rt fa

ilure

are

dis

char

ged

onl

y w

hen

stab

le a

nd r

ecei

ve a

clin

ical

asse

ssm

ent

by

a m

ultid

isci

plin

ary

hear

t fa

ilure

tea

m w

ithin

2 w

eeks

of d

isch

arge

.

15.0

1C

ard

iac

reha

bili

tatio

nN

ICE

CG

108,

1.3

.1.1

: Offe

r a

sup

ervi

sed

gro

up e

xerc

ise-

bas

ed r

ehab

ilita

tion

pro

gram

me

des

igne

d fo

r p

atie

nts

with

hea

rt fa

ilure

.

Ens

ure

the

patie

nt is

sta

ble

and

does

not

hav

e a

cond

ition

or d

evic

e th

at w

ould

pre

clud

e an

exe

rcis

e-ba

sed

reha

bilit

atio

n pr

ogra

mm

e.

Incl

ude

a p

sych

olog

ical

and

ed

ucat

iona

l com

pon

ent

in t

he p

rogr

amm

e.

The

pro

gram

me

may

be

inco

rpor

ated

with

in a

n ex

istin

g ca

rdia

c re

hab

ilita

tion

pro

gram

me.

NIC

E q

ualit

y st

and

ard

8: P

eop

le w

ith s

tab

le c

hron

ic h

eart

failu

re a

nd n

o p

recl

udin

g co

nditi

on o

r d

evic

e ar

e of

fere

d a

sup

ervi

sed

grou

p e

xerc

ise-

bas

ed c

ard

iac

reha

bili

tatio

n p

rogr

amm

e th

at in

clud

es e

duc

atio

n an

d p

sych

olog

ical

sup

por

t.

Clinical guidelines


Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nJu

stifi

cati

on

15.0

5P

allia

tive

care

NIC

E C

G10

8, 1

.5.9

.2: T

he p

allia

tive

need

s of

pat

ient

s an

d ca

rers

sho

uld

be id

entifi

ed, a

sses

sed

and

man

aged

at t

he e

arlie

st o

ppor

tuni

ty.

NIC

E C

G10

8, 1

.5.9

.3: P

atie

nts

with

hea

rt fa

ilure

and

the

ir ca

rers

sho

uld

hav

e ac

cess

to

pro

fess

iona

ls w

ith p

allia

tive

care

ski

lls

with

in t

he h

eart

failu

re t

eam

.

NIC

E q

ualit

y st

and

ard

13:

Peo

ple

with

mod

erat

e to

sev

ere

chro

nic

hear

t fa

ilure

, and

the

ir ca

rer(

s), h

ave

acce

ss t

o a

spec

ialis

t in

hear

t fa

ilure

and

a p

allia

tive

care

ser

vice

.

15.0

6C

OTE

/med

ical

follo

w u

pN

ICE

qua

lity

stan

dar

d 9

: Peo

ple

with

sta

ble

chr

onic

hea

rt fa

ilure

rec

eive

a c

linic

al a

sses

smen

t at

leas

t ev

ery

6 m

onth

s,

incl

udin

g a

revi

ew o

f med

icat

ion

and

mea

sure

men

t of

ren

al fu

nctio

n.

15.0

7C

ard

iolo

gy fo

llow

up

NIC

E q

ualit

y st

and

ard

9: P

eop

le w

ith s

tab

le c

hron

ic h

eart

failu

re r

ecei

ve a

clin

ical

ass

essm

ent

at le

ast

ever

y 6

mon

ths,

incl

udin

g a

revi

ew o

f med

icat

ion

and

mea

sure

men

t of

ren

al fu

nctio

n.

NIC

E q

ualit

y st

and

ard

12:

Peo

ple

ad

mitt

ed t

o ho

spita

l for

hea

rt fa

ilure

are

dis

char

ged

onl

y w

hen

stab

le a

nd r

ecei

ve a

clin

ical

asse

ssm

ent

by

a m

ultid

isci

plin

ary

hear

t fa

ilure

tea

m w

ithin

2 w

eeks

of d

isch

arge

.

15.0

8G

PN

ICE

qua

lity

stan

dar

d 9

: Peo

ple

with

sta

ble

chr

onic

hea

rt fa

ilure

rec

eive

a c

linic

al a

sses

smen

t at

leas

t ev

ery

6 m

onth

s,

incl

udin

g a

revi

ew o

f med

icat

ion

and

mea

sure

men

t of

ren

al fu

nctio

n.

15.1

0D

ate

of d

isch

arge

Use

d t

o ca

lcul

ate

leng

th o

f sta

y an

d t

o ca

lcul

ate

aud

it p

artic

ipat

ion

rate

s.

15.1

1D

isch

arge

pla

nnin

gN

ICE

CG

108,

1.5

.2.1

: Pat

ient

s w

ith h

eart

failu

re s

houl

d g

ener

ally

be

dis

char

ged

from

hos

pita

l onl

y w

hen

thei

r cl

inic

al c

ond

ition

is s

tab

le a

nd t

he m

anag

emen

t p

lan

is o

ptim

ised

. Tim

ing

of d

isch

arge

sho

uld

tak

e in

to a

ccou

nt p

atie

nt a

nd c

arer

wis

hes,

and

the

leve

l of c

are

and

sup

por

t th

at c

an b

e p

rovi

ded

in t

he c

omm

unity

.

NIC

E C

G10

8, 1

.5.2

.2: T

he p

rimar

y ca

re t

eam

, pat

ient

and

car

er m

ust

be

awar

e of

the

man

agem

ent

pla

n.

NIC

E q

ualit

y st

and

ard

10:

Peo

ple

ad

mitt

ed t

o ho

spita

l bec

ause

of h

eart

failu

re h

ave

a p

erso

nalis

ed m

anag

emen

t p

lan

that

is

shar

ed w

ith t

hem

, the

ir ca

rer(

s) a

nd t

heir

GP.

15.1

2W

as a

rev

iew

ap

poi

ntm

ent

with

the

sp

ecia

list

mul

tidis

cip

linar

y H

F te

am m

ade?

NIC

E C

G10

8, 1

.1.1

.4: R

efer

pat

ient

s to

the

sp

ecia

list

mul

tidis

cip

linar

y he

art

failu

re t

eam

for

the

initi

al d

iagn

osis

of h

eart

failu

re

and

the

man

agem

ent

of:

��

seve

re h

eart

failu

re (N

YH

A c

lass

IV)

��

hear

t fa

ilure

tha

t d

oes

not

resp

ond

to

trea

tmen

t

��

hear

t fa

ilure

tha

t ca

n no

long

er b

e m

anag

ed e

ffect

ivel

y in

the

hom

e se

ttin

g.

NIC

E C

G10

8, 1

.5.3

.1: H

eart

failu

re c

are

shou

ld b

e d

eliv

ered

by

a m

ultid

isci

plin

ary

team

with

an

inte

grat

ed a

pp

roac

h ac

ross

the

heal

thca

re c

omm

unity

.

NIC

E q

ualit

y st

and

ard

12:

Peo

ple

ad

mitt

ed t

o ho

spita

l for

hea

rt fa

ilure

are

dis

char

ged

onl

y w

hen

stab

le a

nd r

ecei

ve a

clin

ical

asse

ssm

ent

by

a m

ultid

isci

plin

ary

hear

t fa

ilure

tea

m w

ithin

2 w

eeks

of d

isch

arge

.

15.1

3D

ate

of h

eart

failu

re r

evie

w a

pp

oint

men

t

15.1

4W

as t

he p

atie

nt s

tab

le o

n or

al t

hera

py

afte

r

dis

char

ge p

lann

ing?

NIC

E q

ualit

y st

and

ard

12:

Peo

ple

ad

mitt

ed t

o ho

spita

l for

hea

rt fa

ilure

are

dis

char

ged

onl

y w

hen

stab

le a

nd r

ecei

ve a

clin

ical

asse

ssm

ent

by

a m

ultid

isci

plin

ary

hear

t fa

ilure

tea

m w

ithin

2 w

eeks

of d

isch

arge

.

15.1

5P

atie

nt d

ied

National Heart Failure Audit pro forma


Patient Record

Hospital Hospital #

Forename NHS #

Surname Date of birth / /

Postcode Sex Male / Female

Admission and Symptoms History

Admission date / / 0. No 1. Yes 9.Unknown

IHD

Breathlessness 1. No limitation of physical activity MI

2. Slight limitation of ordinary physical activity Valve disease

3. Marked limitation of ordinary physical activity Hypertension

4. Symptoms at rest or minimal activity Diabetes

9. Unknown COPD

Asthma Physical Examination Diagnosis

[Heart rate, blood pressure, oedema on admission; height & weight at last available

recording]

Peripheral Oedema Confirmed diagnosis of heart failure?Height (cm) 0. No 0. No

Weight (kg) 1. Mild 1. Yes

Heart rate (bpm) 2. Moderate 9. Unknown

Systolic blood pressure 3. Severe

9. Unknown

Investigations [Last available recording]

ECG (current/previous admission) ECHO (or other gold standard test)

Blood tests [More than one value can be selected] e.g MRI,Nuclear Scan or Angio

BNP 1. Sinus rhythm [More than one value can be selected]

Hb 2. Atrial fibrillation 0. Normal

Urea 3. LBBB 1. LV systolic dysfunction

Creatinine 4. Previous MI 2. LV hypertrophy

Electrolytes-NA 6. Not done - planned after discharge 3. Valve disease

Electrolytes-K 7. Not done - not yet planned 4. Diastolic Dysfunction

8. Other 6. Not done - planned after discharge

9. Unknown 7. Not done - not yet planned

8. Other

QRS width 9.Unknown Treatment on discharge

ARB Beta blocker Loop diuretic ARA

0. No 0. No 0. No 0. No

1. Candesartan 1. Bisoprolol 1. Bumetanide 1. Eplerenone

2. Losartan 2. Cardvedilol 2. Ethancrynic acid 2. Spironolactone

3. Valsartan 3. Nebivolol 3. Frusemide 3. Other ARA

4. Other ARB 4. Other beta blocker 4. Torasemide 8. Not applicable

8. Not applicable 8. Not applicable 5. Other loop diuretic 9. Unknown

9. Unknown 9. Unknown 8. Not applicable 10. Drug therapy stopped

10. Drug therapy stopped10. Drug therapy

stopped9. Unknown 12. Declined by patient

11. Contraindicated 11. Contraindicated 10. Drug therapy stopped

12. Declined by patient 12. Declined by patient 11. Contraindicated

12. Declined by patient

7 National Heart Failure Audit pro forma (dataset version 3) Valid from 26/03/12

National Heart Failure Audit pro forma


Treatment on discharge (cont.)

ACE Inhibitor Digoxin Thiazide diureticPrevious device therapy?

0. No 0. No 0. No 0. None

1. Captopril 1. Yes 1. Bendroflumethazide 1. CRT-D

2. Enalapril 8. Not applicable 2. Metolazone 2. CRT-P

3. Lisinopril 9. Unknown 3. Other thiazide 3. ICD

4. Perindopril 10. Drug therapy stopped 8. Not applicable 4. PM

5. Ramipril 11. Contraindicated 9. Unknown 12. Declined by patient

6. Trandolapril 12. Declined by patient 10. Drug therapy stopped

7. Other ACEI 11. Contraindicated

8. Not applicable 12. Declined by patient

9. Unknown

10. Drug therapy stopped

11. Contraindicated

12. Declined by patient

Discharge

Date of discharge / / Did the patient die during this

admission?

Yes / No

Referral to services [If yes, fields relating to treatment on discharge and follow-

up services are not mandatory]

0. No 1. Yes 9. Unknown

Cardiac rehabilitation

HF liaison service

Palliative care

COTE/Medical

Cardiology follow-up

GP

Main place of care Did the patient receive input from a multidisciplinary HF team?1. Cardiology ward 0. No

2. General medical ward 1. Yes

3. Other 9. Unknown

9. Unknown

Which of the following did the patient see? Was a review appointment with the specialist MD HF team made?1. Consultant cardiologist 0. No

2. Other consultant with interest in heart failure 1. Yes

3. Heart failure specialist nurse 9. Unknown

4. Other

9. Unknown Date of appointment / /

Discharge planning

1. A pre-discharge heart failure management plan is in place

2. The management plan has been discussed with the patient

3. The management plan has been communicated to the primary care team

4. All of the above

5. None of the above

9. Unknown

Was the patient stable on oral therapy after discharge planning?

0. No

1. Yes

9. Unknown

7 National Heart Failure Audit pro forma (dataset version 3) Valid from 26/03/12

National Heart Failure Audit core dataset


8 N

atio

nal H

eart

Fai

lure

Aud

it co

re d

atas

et, v

ersi

on 3

17

Va

lid fr

om 2

6/03

/201

217

Th

e d

atas

et c

an b

e d

ownl

oad

ed in

Exc

el fo

rmat

from

the

NIC

OR

web

site

at

http

://w

ww

.ucl

.ac.

uk/n

icor

/aud

its/h

eart

failu

re/d

atas

et.

Rec

ord

Ty

pe

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e N

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gle

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dat

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M

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now

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lue)

M

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22.

Fem

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Text

(sin

gle

valu

e)

99.

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sp

ecifi

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ingl

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n p

lace

of c

are

11.

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dio

logy

Text

(sin

gle

valu

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22.

Gen

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put

from

a m

ultid

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plin

ary

HF

team

?

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Text

(sin

gle

valu

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11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

2.04

aiW

hich

of t

he fo

llow

ing

did

the

pat

ient

see

?

11.

Con

sulta

nt c

ard

iolo

gist

Text

(mul

tival

ue; s

epar

ated

)M

22.

Oth

er c

onsu

ltant

with

inte

rest

in H

FTe

xt (m

ultiv

alue

; sep

arat

ed)

33.

HF

Sp

ecia

list

nurs

eTe

xt (m

ultiv

alue

; sep

arat

ed)

44.

Oth

erTe

xt (m

ultiv

alue

; sep

arat

ed)

99.

Unk

now

nTe

xt (m

ultiv

alue

; sep

arat

ed)




Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

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eFi

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Typ

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and

ato

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3.01

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athl

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11.

No

limita

tion

of p

hysi

cal a

ctiv

ityTe

xt (s

ingl

e va

lue)

M

22.

Slig

ht li

mita

tion

of o

rdin

ary

phy

sica

l act

ivity

Text

(sin

gle

valu

e)

33.

Mar

ked

lim

itatio

n of

ord

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y p

hysi

cal a

ctiv

ityTe

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ingl

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lue)

44.

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pto

ms

at r

est

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inim

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Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

3.04

Per

iphe

ral o

edem

a0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Mild

Text

(sin

gle

valu

e)

22.

Mod

erat

eTe

xt (s

ingl

e va

lue)

33.

Sev

ere

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

4.00

Pre

viou

s IH

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0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

4.01

Pre

viou

s A

MI

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

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2,3

4.09

Pre

viou

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dis

ease

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

4.12

Pre

viou

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per

tens

ion

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

4.14

Pre

viou

s d

iab

etes

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)



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4.14

aP

revi

ous

Ast

hma

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

4.17

Pre

viou

s C

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0. N

oTe

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ingl

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M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

8.01

Hei

ght

Hei

ght

(cm

)N

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ic (r

eal)

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8.02

Wei

ght

Wei

ght

(Kg)

Num

eric

(rea

l)

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8.04

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rt r

ate

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rt r

ate

on a

dm

issi

on (b

mp

)N

umer

ic (i

nteg

er)

2,3

8.06

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od p

ress

ure

- sy

stol

icB

lood

pre

ssur

e -

syst

olic

(mm

Hg)

Num

eric

(int

eger

)

2,3

9.01

Hb

Full

blo

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ount

Hb

Num

eric

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l)

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cou

nt u

rea

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l)

2,3

9.03

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atin

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ount

cre

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l)

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PB

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eger

)

2,3

9.16

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urat

ion

QR

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eric

(int

eger

)

2,3

9.21

EC

G1

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inus

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thm

Text

(mul

tival

ue; s

epar

ated

)M

22.

Atr

ial fi

bril

latio

nTe

xt (m

ultiv

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; sep

arat

ed)

33.

LB

BB

Text

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tival

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epar

ated

)

44.

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viou

s M

ITe

xt (m

ultiv

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; sep

arat

ed)

66.

Not

don

e -

pla

nned

aft

er d

isch

arge

Text

(mul

tival

ue; s

epar

ated

)

77.

Not

don

e -

not

yet

pla

nned

Text

(mul

tival

ue; s

epar

ated

)

88.

Oth

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; sep

arat

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99.

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EC

HO

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MR

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lear

Sca

n or

Ang

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am)

00.

Nor

mal

Text

(mul

tival

ue; s

epar

ated

)M

11.

LV

sys

tolic

dys

func

tion

Text

(mul

tival

ue; s

epar

ated

)

22.

LV

hyp

ertr

ophy

Text

(mul

tival

ue; s

epar

ated

)

33.

Val

ve d

isea

seTe

xt (m

ultiv

alue

; sep

arat

ed)

44.

Dia

stol

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ysfu

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xt (m

ultiv

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; sep

arat

ed)

66.

Tes

t no

t d

one

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lann

ed a

fter

dis

char

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ultiv

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; sep

arat

ed)

77.

Tes

t no

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t ye

t p

lann

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ultiv

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; sep

arat

ed)

88.

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99.

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arat

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2,3

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1Tr

eatm

ent

AC

E in

hib

itor

00.

No

Text

(sin

gle

valu

e)M

11.

Cap

top

rilTe

xt (s

ingl

e va

lue)

22.

Ena

lpril

Text

(sin

gle

valu

e)

33.

Lis

inop

rilTe

xt (s

ingl

e va

lue)

44.

Per

ind

opril

Text

(sin

gle

valu

e)

55.

Ram

ipril

Text

(sin

gle

valu

e)

66.

Tra

ndol

april

Text

(sin

gle

valu

e)

77.

Oth

er A

CE

ITe

xt (s

ingl

e va

lue)

88.

Not

ap

plic

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Text

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gle

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99.

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1010

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trai

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gle

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gle

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Rec

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Des

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ry

2,3

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eatm

ent

AR

B0

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oTe

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lue)

M

11.

Can

des

arta

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ingl

e va

lue)

22.

Los

arta

nTe

xt (s

ingl

e va

lue)

33.

Val

sart

anTe

xt (s

ingl

e va

lue)

44.

Oth

er A

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Text

(sin

gle

valu

e)

88.

Not

ap

plic

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Text

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gle

valu

e)

99.

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1010

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1111

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trai

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Text

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gle

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pat

ient

Text

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gle

valu

e)

2,3

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ent

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a b

lock

er0

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oTe

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ingl

e va

lue)

M

11.

Bis

opro

lol

Text

(sin

gle

valu

e)

22.

Car

ved

ilol

Text

(sin

gle

valu

e)

33.

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ivol

olTe

xt (s

ingl

e va

lue)

44.

Oth

er b

eta

blo

cker

Text

(sin

gle

valu

e)

88.

Not

ap

plic

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Te

xt (s

ingl

e va

lue)

99.

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xt (s

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1010

. Dru

g th

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trai

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Text

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gle

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lined

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pat

ient

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gle

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e)



Rec

ord

Ty

pe

Seq

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Des

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ry

2,3

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eatm

ent

loop

diu

retic

00.

No

Text

(sin

gle

valu

e)M

11.

Bum

etan

ide

Text

(sin

gle

valu

e)

22.

Eth

ancr

ynic

aci

dTe

xt (s

ingl

e va

lue)

33.

Fur

osem

ide

Text

(sin

gle

valu

e)

44.

Tor

asem

ide

Text

(sin

gle

valu

e)

55.

Oth

er lo

op d

iure

ticTe

xt (s

ingl

e va

lue)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

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xt (s

ingl

e va

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1010

. Dru

g th

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1111

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trai

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Text

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gle

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1212

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pat

ient

Text

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gle

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2,3

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eatm

ent

thia

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e d

iure

tic0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Ben

dro

flum

etha

zid

eTe

xt (s

ingl

e va

lue)

22.

Met

olaz

one

Text

(sin

gle

valu

e)

33.

Oth

er t

hiaz

ide

Text

(sin

gle

valu

e)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

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nTe

xt (s

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1010

. Dru

g th

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xt (s

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1111

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trai

ndic

ated

Text

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gle

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e)

1212

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lined

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pat

ient

Text

(sin

gle

valu

e)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

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od

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od

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ato

ry

2,3

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3Tr

eatm

ent

AR

A0

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oTe

xt (s

ingl

e va

lue)

M

11.

Ep

lere

none

Text

(sin

gle

valu

e)

22.

Sp

irono

lact

one

Text

(sin

gle

valu

e)

33.

Oth

er A

RA

Text

(sin

gle

valu

e)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

1010

. Dru

g th

erap

y st

opp

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xt (s

ingl

e va

lue)

1111

. Con

trai

ndic

ated

Text

(sin

gle

valu

e)

1212

. Dec

lined

by

pat

ient

Text

(sin

gle

valu

e)

2,3

11.2

0Tr

eatm

ent

dig

oxin

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

1010

. Dru

g th

erap

y st

opp

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xt (s

ingl

e va

lue)

1111

. Con

trai

ndic

ated

Text

(sin

gle

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1212

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by

pat

ient

Text

(sin

gle

valu

e)

2,3

12.0

1Tr

eatm

ent

dev

ice

ther

apy

00.

Non

eTe

xt (s

ingl

e va

lue)

M

11.

CR

T-D

Text

(sin

gle

valu

e)

22.

CR

T-P

Text

(sin

gle

valu

e)

33.

ICD

Text

(sin

gle

valu

e)

44.

PM

Text

(sin

gle

valu

e)

1212

. Dec

lined

by

pat

ient

Text

(sin

gle

valu

e)

2,3

14.0

0D

iagn

osis

of h

eart

failu

re0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

eM

and

ato

ry

2,3

15.0

0H

F lia

ison

ser

vice

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.0

1C

ard

iac

reha

bili

tatio

n0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Yes

Text

(sin

gle

valu

e)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

1212

. Dec

lined

by

pat

ient

Text

(sin

gle

valu

e)

2,3

15.0

5P

allia

tive

care

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

88.

Not

ap

plic

able

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.0

6C

OTE

/med

ical

follo

w u

p0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.0

7C

ard

iolo

gy fo

llow

up

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.0

8G

P0

0. N

oTe

xt (s

ingl

e va

lue)

M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.1

0D

ate

of d

isch

arge

Dat

e of

dis

char

ge (d

d/m

m/y

yyy)

Dat

e (d

d/m

m/y

yyy)

M



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

eM

and

ato

ry

2,3

15.1

1D

isch

arge

pla

nnin

g1

1. A

hea

rt fa

ilure

pre

-dis

char

ge m

anag

emen

t p

lan

is in

pla

ceTe

xt (s

ingl

e va

lue)

M

22.

A h

eart

-fai

lure

man

agem

ent

pla

n ha

s b

een

dis

cuss

ed w

ith t

he

pat

ient

Text

(sin

gle

valu

e)

33.

A h

eart

failu

re m

anag

emen

t p

lan

has

bee

n co

mm

unic

ated

to

the

prim

ary

care

tea

m

Text

(sin

gle

valu

e)

44.

All

of t

he a

bov

eTe

xt (s

ingl

e va

lue)

55.

Non

e of

the

ab

ove

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.1

2W

as a

rev

iew

ap

poi

ntm

ent

with

the

spec

ialis

t m

ultid

isci

plin

ary

HF

team

mad

e?

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.1

3D

ate

of h

eart

failu

re r

evie

w

app

oint

men

t

Dat

e of

rev

iew

ap

poi

ntm

ent

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

2,3

15.1

4W

as t

he p

atie

nt s

tab

le o

n

oral

the

rap

y af

ter

dis

char

ge

pla

nnin

g?

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

Text

(sin

gle

valu

e)

99.

Unk

now

nTe

xt (s

ingl

e va

lue)

2,3

15.1

5P

atie

nt d

ied

00.

No

Text

(sin

gle

valu

e)M

11.

Yes

416

.01

Eve

nt d

ate

Eve

nt D

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)M

416

.02

Eve

nt1

1. D

eath

Text

(sin

gle

valu

e)M

22.

Ad

mis

sion

for

CH

FTe

xt (s

ingl

e va

lue)

33.

Oth

er C

V a

dm

issi

onTe

xt (s

ingl

e va

lue)

44.

Oth

er n

on-C

V a

dm

issi

onTe

xt (s

ingl

e va

lue)

55.

Uns

ched

uled

OP

vis

itTe

xt (s

ingl

e va

lue)

66.

Oth

er e

vent

Text

(sin

gle

valu

e)

517

.01

Life

sta

tus

dat

eLi

fe s

tatu

s d

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)M

517

.02

Life

sta

tus

11.

Aliv

eTe

xt (s

ingl

e va

lue)

M

22.

Dea

dTe

xt (s

ingl

e va

lue)

National Heart Failure Audit full dataset


9 N

atio

nal H

eart

Fai

lure

Aud

it fu

ll da

tase

t, ve

rsio

n 31

8

Valid

from

26/

03/2

012

18

The

dat

aset

can

be

dow

nloa

ded

in E

xcel

form

at fr

om t

he N

ICO

R w

ebsi

te a

t ht

tp:/

/ww

w.u

cl.a

c.uk

/nic

or/a

udits

/hea

rtfa

ilure

/dat

aset

.

Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

1,2,

3,4,

51.

01H

osp

ital i

den

tifier

Text

(sin

gle

valu

e)

1,2,

3,4,

51.

02Lo

cal P

atie

nt Id

entifi

erFr

ee t

ext

Free

tex

t

11.

03N

HS

Num

ber

10 d

igit

(no

spac

es) v

alid

NH

S N

umb

erFr

ee t

ext

11.

04P

atie

nt N

ame

(Sur

nam

e)Fr

ee t

ext

Free

tex

t

11.

05P

atie

nt N

ame

(For

enam

e)Fr

ee t

ext

Free

tex

t

11.

06B

irth

Dat

eVa

lid d

ate

>19

01 a

nd <

=19

95D

ate

(dd

/mm

/yyy

y)

11.

07P

atie

nt G

end

er0

0. N

ot k

now

nTe

xt (s

ingl

e va

lue)

11.

Mal

e

22.

Fem

ale

99.

Not

sp

ecifi

ed

11.

08P

atie

nt E

thni

c G

roup

11.

Cau

casi

anTe

xt (s

ingl

e va

lue)

22.

Bla

ck

33.

Asi

an

44.

Orie

ntal

88.

Oth

er

99.

Unk

now

n

11.

09P

ostc

ode

Of U

sual

Ad

dre

ssVa

lid P

ost

Cod

eFr

ee t

ext

11.

10Li

ving

Alo

ne0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

11.

11O

ther

Soc

ial I

ssue

s1

1. S

tairs

at

hom

eTe

xt (m

ultiv

alue

; sep

arat

ed)

22.

Tra

nsp

ort

33.

Car

er

44.

Acc

omm

odat

ion




Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

11.

12O

ccup

atio

n1

1. P

rofe

ssio

nal/M

anag

eria

lTe

xt (s

ingl

e va

lue)

22.

Cle

rical

33.

Man

ual

44.

Une

mp

loye

d

55.

Ret

ired

66.

Oth

er

11.

13G

P N

ame

GP

Nam

eFr

ee t

ext

2,3

2.00

Dat

e of

Ad

mis

sion

Dat

e of

Ad

mis

sion

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

22.

01R

efer

ral R

easo

n1

1. K

now

n ca

se o

f hea

rt fa

ilure

prio

r to

ref

erra

lTe

xt (m

ultiv

alue

; sep

arat

ed)

22.

Sus

pec

ted

hea

rt fa

ilure

(eg:

- ad

mis

sion

with

acu

te

bre

athl

essn

ess

or r

efer

ral w

ith o

edem

a or

incr

easi

ng

bre

athl

essn

ess

on e

xert

ion)

33.

Sus

pec

ted

LV

dys

func

tion

(eg:

- p

ost-

MI,

sub

seq

uent

to

an

arrh

ythm

ia)

44.

Inve

stig

atio

n of

nee

d fo

r (lo

op) d

iure

tics

55.

Oth

er

22.

02R

efer

ral R

oute

11.

Dia

gnos

ed a

nd m

anag

ed in

prim

ary

care

alo

neTe

xt (s

ingl

e va

lue)

22.

Hos

pita

l out

-pat

ient

from

prim

ary

care

33.

Hos

pita

l out

-pat

ient

from

sec

ond

ary

care

(cou

ld

incl

ude

card

iolo

gy, C

OTE

and

oth

er)

44.

Urg

ent

adm

issi

on fo

r or

with

hea

rt fa

ilure

55.

In-p

atie

nt d

iagn

osis

of H

F af

ter

urge

nt a

dm

issi

on fo

r ot

her

CV

con

diti

on

66.

In-p

atie

nt d

iagn

osis

of H

F af

ter

urge

nt a

dm

issi

on fo

r no

n-C

V c

ond

ition

77.

In-p

atie

nt d

iagn

osis

of H

F af

ter

rout

ine

CV

ad

mis

sion

88.

In-p

atie

nt d

iagn

osis

of H

F af

ter

rout

ine

non-

CV

ad

mis

sion

99.

Oth

er r

efer

ral r

oute



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

2.03

Rec

ent

inp

atie

nt1

1. C

ard

iolo

gyTe

xt (s

ingl

e va

lue)

22.

Gen

eral

Med

icin

e

33.

Oth

er

2,3

2.04

Mai

n p

lace

of c

are

11.

Car

dio

logy

Text

(sin

gle

valu

e)

22.

Gen

eral

Med

icin

e

33.

Oth

er

99.

Unk

now

n

2,3

2.04

aR

ecei

ved

inp

ut fr

om a

mul

tidis

cip

linar

y H

F Te

am0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

2.04

aiW

hich

of t

he fo

llow

ing

did

the

pat

ient

see

?1

1. C

onsu

ltant

car

dio

logi

stTe

xt (m

ultiv

alue

; sep

arat

ed)

22.

Oth

er c

onsu

ltant

with

inte

rest

in h

eart

failu

re

33.

HF

Sp

ecia

list

nurs

e

44.

Oth

er

99.

Unk

now

n

32.

05U

nsch

edul

ed E

vent

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

32.

06In

pat

ient

00.

No

Text

(sin

gle

valu

e)

11.

Yes

32.

07O

utp

atie

nt0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

2,3

3.01

Bre

athl

essn

ess

11.

No

limita

tion

of p

hysi

cal a

ctiv

ityTe

xt (s

ingl

e va

lue)

22.

Slig

ht li

mita

tion

of o

rdin

ary

phy

sica

l act

ivity

33.

Mar

ked

lim

itatio

n of

ord

inar

y p

hysi

cal a

ctiv

ity

44.

Sym

pto

ms

at r

est

or m

inim

al a

ctiv

ity

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

3.02

CC

S A

ngin

a S

tatu

s0

0. N

o an

gina

Text

(sin

gle

valu

e)

11.

Ang

ina

whi

ch d

oes

not

limit

ord

inar

y p

hysi

cal a

ctiv

ity.

22.

Slig

ht li

mita

tion

of o

rdin

ary

activ

ity

33.

Mar

ked

lim

itatio

n of

ord

inar

y p

hysi

cal a

ctiv

ity

44.

Inab

ility

to

per

form

any

phy

sica

l act

ivity

with

out

dis

com

fort

2,3

3.03

Fatig

ue0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Mild

22.

Mod

erat

e

33.

Sev

ere

99.

Unk

now

n

2,3

3.04

Per

iphe

ral O

edem

a0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Mild

22.

Mod

erat

e

33.

Sev

ere

99.

Unk

now

n

2,3

3.05

Oth

er S

ymp

tom

Oth

er S

ymp

tom

Free

tex

t

2,3

4.00

Pre

viou

s IH

D0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.01

Pre

viou

s A

MI

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.02

Pre

viou

s M

I Dat

eP

revi

ous

MI D

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

2,3

4.03

Pre

viou

s C

AB

G0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.04

CA

BG

Dat

eC

AB

G D

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

4.05

Pre

viou

s P

CI

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.06

PC

I Dat

eP

CI D

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

2,3

4.07

Pre

viou

s D

evic

e Th

erap

y1

1. C

RT-

DTe

xt (s

ingl

e va

lue)

22.

CR

T-P

33.

ICD

44.

PM

2,3

4.08

Pre

viou

s D

evic

e M

ode

11.

AA

ITe

xt (s

ingl

e va

lue)

22.

AA

IR

33.

DD

D

44.

DD

DR

55.

OO

O

66.

VV

I

77.

VV

IR

2,3

4.09

Pre

viou

s Va

lve

Dis

ease

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.10

Pre

viou

s C

onge

nita

l hea

rt d

isea

se0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.11

Pre

viou

s A

rrhy

thm

ia0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.12

Pre

viou

s H

yper

tens

ion

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

4.13

Pre

viou

s C

hron

ic R

enal

Imp

airm

ent

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.14

Pre

viou

s D

iab

etes

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.14

aP

revi

ous

Ast

hma

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.15

Pre

viou

s C

VA0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.16

Pre

viou

s P

VD

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.17

Pre

viou

s C

OP

D0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

4.18

Pre

viou

s A

rthr

itis

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.19

Pre

viou

s G

out

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

4.20

Pas

t M

edic

al H

isto

ry O

ther

Pas

t M

edic

al H

isto

ry O

ther

Free

tex

t

2,3

5.01

Soc

ial H

isto

ry A

lcoh

olS

ocia

l His

tory

Alc

ohol

(uni

ts/w

eek)

Num

eric

(int

eger

)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

5.02

Soc

ial H

isto

ry S

mok

ing

11.

Yes

Text

(sin

gle

valu

e)

22.

Ex

33.

Nev

er

2,3

6.01

Fam

ily h

isto

ry H

F0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

6.02

Fam

ily h

isto

ry IH

D/O

ther

car

dia

c0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

6.03

Fam

ily h

isto

ry M

uscu

lar

Dys

trop

hy0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

6.04

Fam

ily h

isto

ry C

ard

iom

yop

athy

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

7.01

AC

EI

00.

No

Text

(sin

gle

valu

e)

11.

Cap

top

ril

22.

Ena

lap

ril

33.

Lis

inop

ril

44.

Per

ind

opril

55.

Ram

ipril

66.

Tra

ndol

april

77.

Oth

er A

CE

I

99.

Unk

now

n

2,3

7.02

AC

EI D

ose

AC

EI D

ose

Num

eric

(rea

l)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

7.03

AC

E I

Rea

son

11.

Cou

ghTe

xt (s

ingl

e va

lue)

22.

Low

Art

eria

l Pre

ssur

e

33.

Ren

al d

ysfu

nctio

n

44.

Oth

er in

tole

ranc

e to

AC

E

55.

Not

ind

icat

ed

2,3

7.04

AR

B0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Can

des

arta

n

22.

Los

arta

n

33.

Val

sart

an

44.

Oth

er A

RB

99.

Unk

now

n

2,3

7.05

AR

B D

ose

AR

B D

ose

Num

eric

(rea

l)

2,3

7.06

Bet

a B

lock

er0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Bis

opro

lol

22.

Car

dve

dilo

l

33.

Neb

ivol

ol

44.

Oth

er b

eta

blo

cker

99.

Unk

now

n

2,3

7.07

Bet

a D

ose

Bet

a b

lock

er D

ose

Num

eric

(rea

l)

2,3

7.08

Bet

a b

lock

er R

easo

n1

1. B

rad

ycar

dia

or

Hea

rt B

lock

Text

(sin

gle

valu

e)

22.

Low

Art

eria

l Pre

ssur

e

33.

Wor

sten

ing

Hea

rt F

ailu

re

44.

Into

lera

ble

Fat

igue

55.

Res

pira

tory

Dis

ease

66.

Oth

er In

tole

ranc

e

77.

Not

ind

icat

ed



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

7.09

Diu

retic

: loo

p0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Bum

etan

ide

22.

Eth

ancr

ynic

aci

d

33.

Fru

sem

ide

44.

Tor

asem

ide

99.

Unk

now

n

2,3

7.10

Loop

Dos

eLo

op D

ose

Num

eric

(rea

l)

2,3

7.11

Diu

retic

: Thi

azid

e0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Ben

dro

flum

etha

zid

e

22.

Met

olaz

one

33.

Oth

er T

hiaz

ide

99.

Unk

now

n

2,3

7.12

Thia

zid

e D

ose

Thia

zid

e D

ose

Num

eric

(rea

l)

2,3

7.13

SA

RA

00.

No

Text

(sin

gle

valu

e)

11.

Ep

lere

none

22.

Sp

irono

lact

one

99.

Unk

now

n

2,3

7.14

SA

RA

Rea

son

11.

Hyp

erka

lem

iaTe

xt (s

ingl

e va

lue)

22.

Ren

al D

ysfu

nctio

n

33.

Gyn

aeco

mas

tia

44.

Oth

er

55.

Not

ind

icat

ed

2,3

7.15

SA

RA

Dos

eS

AR

A D

ose

Num

eric

(rea

l)

2,3

7.16

Asp

irin

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

7.17

Asp

irin

Dos

eA

spiri

n D

ose

Num

eric

(int

eger

)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

7.18

7.18

7.18

7.18

Oth

er o

ral a

nti-

pla

tele

t0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Clo

pid

ogre

l

22.

Oth

er o

ral a

ntip

late

let

99.

Unk

now

n

2,3

7.19

Oth

er A

nti-

pla

tele

t D

ose

Oth

er A

nti-

pla

tele

t D

ose

Num

eric

(int

eger

)

2,3

7.20

Dig

oxin

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

7.21

Dig

oxin

Dos

eD

igox

in D

ose

Num

eric

(rea

l)

2,3

7.22

CC

B0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Am

lod

ipin

e

22.

Fel

odip

ine

33.

Dilt

iaze

m

44.

Ver

apam

il

55.

Oth

er C

CB

99.

Unk

now

n

2,3

7.23

CC

B D

ose

CC

B D

ose

Num

eric

(int

eger

)

2,3

7.24

Ther

apy

for

Lip

ids

00.

No

Text

(sin

gle

valu

e)

11.

Ato

rvas

tatin

22.

Pra

vast

atin

33.

Ros

uvas

tatin

44.

Sim

vast

atin

99.

Unk

now

n

2,3

7.25

Ther

apy

for

Lip

ids

Dos

eTh

erap

y fo

r Li

pid

s D

ose

Num

eric

(int

eger

)

2,3

7.26

7.26

7.26

War

farin

HF

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

7.27

INR

INR

Num

eric

(rea

l)

2,3

7.28

War

farin

Dos

eW

arfa

rin D

ose

Num

eric

(rea

l)

2,3

7.29

Am

iod

aron

e0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

7.30

Am

iod

aron

e D

ose

Am

iod

aron

e D

ose

Num

eric

(int

eger

)

2,3

7.31

Allo

pur

inol

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

7.32

Allo

pur

inol

Dos

eA

llop

urin

ol D

ose

Num

eric

(int

eger

)

2,3

7.33

NS

AID

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

7.34

Nitr

ates

HF

00.

No

Text

(sin

gle

valu

e)

11.

ISD

N

22.

ISM

N

99.

Unk

now

n

2,3

7.35

Nitr

ate

Dos

eN

itrat

e D

ose

Num

eric

(int

eger

)

2,3

7.36

Bro

ncho

dila

tors

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

7.37

Cur

rent

Dia

bet

es T

hera

py

00.

Not

dia

bet

icTe

xt (s

ingl

e va

lue)

11.

Dia

bet

es (d

ieta

ry c

ontr

ol)

22.

Met

form

ine

33.

Sul

pho

nylu

rea

44.

Glit

azon

e

55.

Oth

er O

ral

66.

Dia

bet

ic (i

nsul

in)

77.

New

ly d

iagn

osed

dia

bet

ic

99.

Unk

now

n

2,3

7.38

Cur

rent

Tria

l Med

icat

ion

Cur

rent

Tria

l Med

icat

ion

Free

tex

t

2,3

7.39

Oth

er t

reat

men

tO

ther

tre

atm

ent

Free

tex

t

2,3

8.01

Hei

ght

Hei

ght

(cm

)N

umer

ic (r

eal)

2,3

8.02

Wei

ght

Wei

ght

(Kg)

Num

eric

(rea

l)

2,3

8.03

BM

IB

MI

Num

eric

(rea

l)

2,3

8.04

Hea

rt r

ate

Hea

rt r

ate

on a

dm

issi

on (b

pm

)N

umer

ic (i

nteg

er)

2,3

8.05

Hea

rt R

hyth

m1

1. R

egul

arTe

xt (s

ingl

e va

lue)

22.

Irre

gula

r

2,3

8.06

Blo

od p

ress

ure

- sy

stol

icB

lood

pre

ssur

e -

syst

olic

(mm

Hg)

Num

eric

(int

eger

)

2,3

8.07

Blo

od p

ress

ure

- d

iast

olic

Blo

od p

ress

ure

- d

iast

olic

Num

eric

(int

eger

)

2,3

8.08

JVP

11.

Invi

sib

leTe

xt (s

ingl

e va

lue)

22.

Rai

sed

33.

Nor

mal

2,3

8.09

Mur

mur

s1

1. S

ysto

licTe

xt (m

ultiv

alue

; sep

arat

ed)

22.

Dia

stol

ic

2,3

8.10

Ad

ded

Hea

rt S

ound

s1

1. S

3Te

xt (m

ultiv

alue

; sep

arat

ed)

22.

S4



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

8.11

Lung

Fie

lds

11.

Cle

arTe

xt (s

ingl

e va

lue)

22.

Ral

es

2,3

8.13

Phy

sica

l Exa

m O

ther

P

hysi

cal E

xam

Oth

erFr

ee t

ext

2,3

9.01

Hb

Full

blo

od c

ount

Hb

Num

eric

(rea

l)

2,3

9.02

Ure

aFu

ll b

lood

cou

nt u

rea

Num

eric

(rea

l)

2,3

9.03

Cre

atin

ine

Full

blo

od c

ount

cre

atin

ine

Num

eric

(int

eger

)

2,3

9.04

Ele

ctro

lyte

s-N

AE

lect

roly

tes-

NA

Num

eric

(int

eger

)

2,3

9.05

Ele

ctro

lyte

s-K

Ele

ctro

lyte

s-K

Num

eric

(rea

l)

2,3

9.06

Bili

rub

inLF

Ts B

iliru

bin

Num

eric

(int

eger

)

2,3

9.07

AS

TLF

Ts A

ST

Num

eric

(int

eger

)

2,3

9.08

ALT

LFTs

ALT

Num

eric

(int

eger

)

2,3

9.09

Gam

maG

TLF

Ts G

amm

aGT

Num

eric

(int

eger

)

2,3

9.10

Glu

cose

Glu

cose

Num

eric

(rea

l)

2,3

9.11

TSH

TFTs

TS

HN

umer

ic (r

eal)

2,3

9.12

T4TF

Ts T

4N

umer

ic (r

eal)

2,3

9.13

BN

PB

NP

Num

eric

(int

eger

)

2,3

9.14

NT-

BN

PN

T-B

NP

Num

eric

(int

eger

)

2,3

9.15

Tota

l Cho

lest

erol

Tota

l Cho

lest

erol

Num

eric

(rea

l)

2,3

9.16

QR

S D

urat

ion

QR

S D

urat

ion

Num

eric

(int

eger

)

2,3

9.17

QT

Dur

atio

n (U

ncor

rect

ed)

QT

Dur

atio

n (u

ncor

rect

ed)

Num

eric

(int

eger

)

2,3

9.18

LBB

B0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.19

RB

BB

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

9.20

EC

G P

revi

ous

MI

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.21

EC

G1

1. S

inus

rhy

thm

Text

(mul

tival

ue; s

epar

ated

)

22.

Atr

ial fi

bril

latio

n

33.

LB

BB

44.

Pre

viou

s M

I

66.

Not

don

e -

pla

nned

aft

er d

isch

arge

77.

Not

don

e -

not

yet

pla

nned

88.

Oth

er

99.

Unk

now

n

2,3

9.22

EC

G R

ate

EC

G R

ate

Num

eric

(int

eger

)

2,3

9.23

EC

HO

(or

othe

r go

ld s

tand

ard

tes

t e.

g M

RI,N

ucle

ar

Sca

n or

Ang

iogr

am)

00.

Nor

mal

Text

(mul

tival

ue; s

epar

ated

)

11.

LV

sys

tolic

dys

func

tion

22.

LV

hyp

ertr

ophy

33.

Val

ve d

isea

se

44.

Dia

stol

ic d

ysfu

nctio

n

66.

Tes

t no

t d

one

- p

lann

ed a

fter

dis

char

ge

77.

Tes

t no

t d

one

- no

t ye

t p

lann

ed

88.

Oth

er

99.

Unk

now

n

2,3

9.24

Ech

o S

ysto

lic d

ysfu

nctio

n0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.25

Ech

o D

iast

olic

dys

func

tion

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

9.26

Ech

o A

ortic

Val

ve d

isea

se0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Ste

nosi

s

22.

Reg

urgi

tatio

n

33.

Ste

nosi

s an

d R

egur

gita

tion

99.

Unk

now

n

2,3

9.27

Ech

o M

itral

Val

ve D

isea

se0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Ste

nosi

s

22.

Reg

urgi

tatio

n

33.

Ste

nosi

s an

d R

egur

gita

tion

99.

Unk

now

n

2,3

9.28

Ech

o O

ther

Ech

o O

ther

Free

tex

t

2,3

9.29

MR

I Sys

tolic

Dys

func

tion

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.30

MR

I Dia

stol

ic D

ysfu

nctio

n0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.31

MU

GA

LV

EF

Ab

norm

al0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.32

MU

GA

Ind

ucib

le Is

chae

mia

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.33

Che

st X

Car

dio

thor

acic

rat

ioC

ard

ioth

orac

ic r

atio

Num

eric

(rea

l)

2,3

9.34

Che

st X

ULV

D0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

9.35

Che

st X

Pul

mon

ary

Oed

ema

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.36

Tota

l Exc

erci

se m

inut

esTo

tal E

xerc

ise

min

utes

Num

eric

(int

eger

)

2,3

9.37

Tota

l Exc

erci

se s

econ

ds

Tota

l Exe

rcis

e se

cond

sN

umer

ic (i

nteg

er)

2,3

9.38

ETT

Che

st P

ain

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.39

ETT

ST

Dep

ress

ion

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.40

Ang

io L

V d

ysfu

nctio

n0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.41

Ang

io L

Mai

n0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.42

Ang

io L

AD

pro

x0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.43

Ang

io L

AD

dis

t0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

9.44

Ang

io L

CX

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

9.45

Ang

io R

CA

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

9.46

Oth

er t

est

Pas

t M

edic

al H

isto

ry O

ther

Free

tex

t

2,3

11.0

1Tr

eatm

ent

AC

E I

00.

No

Text

(sin

gle

valu

e)

11.

Cap

top

ril

22.

Ena

lpril

33.

Lis

inop

ril

44.

Per

ind

opril

55.

Ram

ipril

66.

Tra

ndol

april

77.

Oth

er A

CE

I

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.0

2Tr

eatm

ent

AC

EI D

ose

Trea

tmen

t A

CE

I Dos

eN

umer

ic (r

eal)

2,3

11.0

3Tr

eatm

ent

AC

E I

reas

on1

1. C

ough

Text

(sin

gle

valu

e)

22.

Low

Art

eria

l Pre

ssur

e

33.

Ren

al d

ysfu

nctio

n

44.

Oth

er in

tole

ranc

e to

AC

E

55.

Not

Ind

icat

ed



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.0

4Tr

eatm

ent

AR

B0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Can

des

arta

n

22.

Los

arta

n

33.

Val

sart

an

44.

Oth

er A

RB

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.0

5Tr

eatm

ent

AR

B D

ose

Trea

tmen

t A

RB

Dos

eN

umer

ic (r

eal)

2,3

11.0

6Tr

eatm

ent

Bet

a b

lock

er0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Bis

opro

lol

22.

Car

ved

ilol

33.

Neb

ivol

ol

44.

Oth

er b

eta

blo

cker

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.0

7Tr

eatm

ent

Bet

a b

lock

er D

ose

Trea

tmen

t b

eta

blo

cker

Dos

eN

umer

ic (r

eal)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.0

8Tr

eatm

ent

Bet

a re

ason

11.

Bra

dyc

ard

ia o

r H

eart

Blo

ckTe

xt (s

ingl

e va

lue)

22.

Low

Art

eria

l Pre

ssur

e

33.

Wor

seni

ng H

eart

Fai

lure

44.

Into

lera

ble

Fat

igue

55.

Res

pira

tory

Dis

ease

66.

Oth

er In

tole

ranc

e

77.

Not

Ind

icat

ed

2,3

11.0

9Tr

eatm

ent

Loop

Diu

retic

00.

No

Text

(sin

gle

valu

e)

11.

Bum

etan

ide

22.

Eth

ancr

ynic

aci

d

33.

Fur

osem

ide

44.

Tor

asem

ide

55.

Oth

er lo

op d

iure

tic

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.1

0Tr

eatm

ent

Loop

Dos

eTr

eatm

ent

Loop

Dos

eN

umer

ic (r

eal)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.1

1Tr

eatm

ent

Thia

zid

e D

iure

tic0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Ben

dro

flum

etha

zid

e

22.

Met

olaz

one

33.

Oth

er t

hiaz

ide

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.1

2Tr

eatm

ent

Thia

zid

e D

ose

Thia

zid

e D

ose

Num

eric

(rea

l)

2,3

11.1

3Tr

eatm

ent

AR

A0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Ep

lere

none

22.

Sp

irono

lact

one

33.

Oth

er A

RA

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.1

4Tr

eatm

ent

AR

A R

easo

n1

1. H

yper

kale

mia

Text

(sin

gle

valu

e)

22.

Ren

al D

ysfu

nctio

n

33.

Gyn

aeco

mas

tia

44.

Oth

er

55.

Not

Ind

icat

ed

2,3

11.1

5Tr

eatm

ent

AR

A D

ose

AR

A D

ose

Num

eric

(rea

l)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.1

6Tr

eatm

ent

Asp

irin

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.1

7Tr

eatm

ent

Asp

irin

Dos

eTr

eatm

ent

Asp

irin

Dos

eN

umer

ic (i

nteg

er)

2,3

11.1

8Tr

eatm

ent

Oth

er o

ral a

nti-

pla

tele

t0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Clo

pid

ogre

l

22.

Oth

er o

ral a

ntip

late

let

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.1

9Tr

eatm

ent

Oth

er A

nti-

pla

tele

t D

ose

Trea

tmen

t O

ther

Ant

i-p

late

let

Dos

eN

umer

ic (i

nteg

er)

2,3

11.2

0Tr

eatm

ent

Dig

oxin

00.

No

Text

(sin

gle

valu

e)

11.

Yes

88.

Not

ap

plic

able

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

1111

. Con

trai

ndic

ated

1212

. Dec

lined

by

pat

ient

2,3

11.2

1Tr

eatm

ent

Dig

oxin

Dos

eTr

eatm

ent

Dig

oxin

Dos

eN

umer

ic (r

eal)

2,3

11.2

2Tr

eatm

ent

CC

B0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Am

lod

ipin

e

22.

Fel

odip

ine

33.

Dilt

iaze

m

44.

Ver

apam

il

55.

Oth

er C

CB

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.2

3Tr

eatm

ent

CC

B D

ose

Trea

tmen

t C

CB

Dos

eN

umer

ic (i

nteg

er)

2,3

11.2

4Tr

eatm

ent

Ther

apy

for

Lip

ids

00.

No

Text

(sin

gle

valu

e)

11.

Ato

rvas

tatin

22.

Pra

vast

atin

33.

Ros

uvas

tatin

44.

Sim

vast

atin

55.

Oth

er L

ipid

66.

Fib

rate

77.

Eze

timib

e

88.

Oth

er L

ipid

The

rap

y

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.2

5Tr

eatm

ent

Ther

apy

for

Lip

ids

Dos

eTr

eatm

ent

Ther

apy

for

Lip

ids

Dos

eN

umer

ic (i

nteg

er)

2,3

11.2

6Tr

eatm

ent

War

farin

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.2

7Tr

eatm

ent

INR

Trea

tmen

t IN

RN

umer

ic (r

eal)

2,3

11.2

8Tr

eatm

ent

War

farin

Dos

eTr

eatm

ent

War

farin

Dos

eN

umer

ic (r

eal)

2,3

11.2

9Tr

eatm

ent

Am

iod

aron

e0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.3

0Tr

eatm

ent

Am

iod

aron

e D

ose

Trea

tmen

t A

mio

dar

one

Dos

eN

umer

ic (i

nteg

er)



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.3

1Tr

eatm

ent

Allo

pur

inol

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.3

2Tr

eatm

ent

Allo

pur

inol

Dos

eTr

eatm

ent

Allo

pur

inol

Dos

eN

umer

ic (i

nteg

er)

2,3

11.3

3Tr

eatm

ent

NS

AID

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.3

4Tr

eatm

ent

Nitr

ates

00.

No

Text

(sin

gle

valu

e)

11.

ISD

N

22.

ISM

N

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.3

5Tr

eatm

ent

Nitr

ate

Dos

eTr

eatm

ent

Nitr

ate

Dos

eN

umer

ic (i

nteg

er)

2,3

11.3

6Tr

eatm

ent

Bro

ncho

dila

tors

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

1010

. Dru

g th

erap

y st

opp

ed

2,3

11.3

7Tr

eatm

ent

Dia

bet

es t

hera

py

00.

Not

dia

bet

icTe

xt (s

ingl

e va

lue)

11.

Dia

bet

es (d

ieta

ry c

ontr

ol)

22.

Met

form

ine

33.

Sul

pho

nylu

rea

44.

Glit

azon

e

55.

Oth

er O

ral

66.

Dia

bet

ic (i

nsul

in)

77.

New

ly d

iagn

osed

dia

bet

ic

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

11.3

8O

ther

Tre

atm

ent

Free

tex

tFr

ee t

ext

2,3

11.3

9Tr

eatm

ent

clin

ical

tria

l med

icat

ion

Free

tex

tFr

ee t

ext

2,3

12.0

1Tr

eatm

ent

Dev

ice

ther

apy

00.

Non

eTe

xt (s

ingl

e va

lue)

11.

CR

T-D

22.

CR

T-P

33.

ICD

44.

PM

1212

. Dec

lined

by

pat

ient

2,3

12.0

2Tr

eatm

ent

Dev

ice

Mod

e1

1. A

AI

Text

(sin

gle

valu

e)

22.

AA

IR

33.

DD

D

44.

DD

DR

55.

OO

O

66.

VV

I

77.

VV

IR

2,3

12.0

3Tr

eatm

ent

card

iac

surg

ery

11.

CA

BG

Text

(mul

tival

ue; s

epar

ated

)

22.

MV

R

33.

Oth

er v

alve

sur

gery

44.

Car

dia

c tr

ansp

lant

88.

Oth

er

2,3

12.0

4Tr

eatm

ent

PC

I0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

12.0

5Tr

eatm

ent

VAD

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

12.0

6Tr

eatm

ent

card

iac

rhyt

hm m

anag

emen

t1

1. E

P s

tud

yTe

xt (s

ingl

e va

lue)

22.

Inte

rven

tion

(uns

pec

ified

)

33.

Inte

rven

tion

(pul

mon

ary

vein

isol

atio

n)

44.

Oth

er

2,3

13.0

1Q

OL

Min

neso

taQ

OL

Min

neso

taN

umer

ic (r

eal)

2,3

13.0

2Q

OL

VAS

QO

L VA

SN

umer

ic (i

nteg

er)

2,3

13.0

3Q

OL

Oth

erQ

OL

Oth

erN

umer

ic (i

nteg

er)

2,3

14.0

0D

x H

eart

Fai

lure

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

14.0

1D

x Is

chae

mic

hea

rt d

isea

se0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.0

2D

x Va

lve

dis

ease

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

14.0

3D

x H

yper

tens

ion

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

14.0

4D

x A

rrhy

thm

ia0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.0

5D

x A

lcoh

ol0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

14.0

6D

x C

ard

iom

yop

athy

00.

No

Text

(sin

gle

valu

e)

11.

DC

M

22.

HC

M

88.

Oth

er

99.

Unk

now

n

2,3

14.0

7D

x A

sym

pto

mat

ic L

VS

D0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.0

8D

x C

OP

D0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.0

9D

x O

bes

ity0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.1

0D

x D

econ

diti

onin

g0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.1

1D

x A

naem

ia0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.1

2D

x P

ulm

onar

y E

mb

olis

m0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

14.1

3O

ther

dia

gnos

isO

ther

dia

gnos

isFr

ee t

ext

2,3

15.0

0H

F Li

aiso

n S

ervi

ce0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

15.0

1C

ard

iac

Reh

abili

tatio

n0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

88.

Not

ap

plic

able

99.

Unk

now

n

1212

. Dec

lined

by

pat

ient

2,3

15.0

2S

ocia

l Wor

k0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

15.0

3C

ard

ioth

orac

ic S

urge

ry0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

15.0

4Tr

ansp

lant

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

15.0

5P

allia

tive

Car

e0

0. N

oTe

xt (s

ingl

e va

lue)

Text

(sin

gle

valu

e)1

1. Y

es

88.

Not

ap

plic

able

99.

Unk

now

n

2,3

15.0

6C

OTE

/Med

ical

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

15.0

7C

ard

iolo

gy F

U0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

15.0

8G

P0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

2,3

15.0

9O

ther

FU O

ther

Text

(sin

gle

valu

e)

2,3

15.1

0D

ate

of d

isch

arge

Dat

e of

dis

char

ge (d

d/m

m/y

yyy)

Dat

e (d

d/m

m/y

yyy)

2,3

15.1

1D

isch

arge

Pla

nnin

g1

1. A

hea

rt fa

ilure

pre

-dis

char

ge m

anag

emen

t p

lan

is in

p

lace

Text

(sin

gle

valu

e)

22.

A h

eart

-fai

lure

man

agem

ent

pla

n ha

s b

een

dis

cuss

ed

with

the

pat

ient

33.

A h

eart

failu

re m

anag

emen

t p

lan

has

bee

n co

mm

unic

ated

to

the

prim

ary

care

tea

m

44.

All

of t

he a

bov

e

55.

Non

e of

the

ab

ove

99.

Unk

now

n

2,3

15.1

2A

rev

iew

ap

poi

ntm

ent

with

the

sp

ecia

list

MD

hea

rt

failu

re t

eam

mad

e0

0. N

oTe

xt (s

ingl

e va

lue)

11.

Yes

99.

Unk

now

n

2,3

15.1

3D

ate

of h

eart

failu

re r

evie

w a

pp

oint

men

tD

ate

of r

evie

w a

pp

oint

men

t (d

d/m

m/y

yyy)

Dat

e (d

d/m

m/y

yyy)

2,3

15.1

4W

as t

he p

atie

nt s

tab

le o

n or

al t

hera

py

afte

r d

isch

arge

p

lann

ing?

00.

No

Text

(sin

gle

valu

e)

11.

Yes

99.

Unk

now

n

2,3

15.1

5P

atie

nt d

ied

00.

No

Text

(sin

gle

valu

e)

11.

Yes

416

.01

Eve

nt d

ate

Eve

nt D

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

416

.02

Eve

nt1

1. D

eath

Text

(sin

gle

valu

e)

22.

Ad

mis

sion

for

CH

F

33.

Oth

er C

V a

dm

issi

on

44.

Oth

er n

on-C

V a

dm

issi

on

55.

Uns

ched

uled

OP

vis

it

66.

Oth

er e

vent



Rec

ord

Ty

pe

Seq

uenc

e N

umb

erFi

eld

Des

crip

tio

nS

hort

C

od

eLo

ng C

od

eFi

eld

Typ

e

416

.03

Hos

pita

lisat

ion

(trea

tmen

t)1

1. N

eed

for

IV d

iure

tics

Text

(mul

tival

ue; s

epar

ated

)

22.

Nee

d fo

r C

PAP

416

.04

Hos

pita

lisat

ion

(dur

atio

n)H

osp

italis

atio

n (d

urat

ion)

Num

eric

(int

eger

)

517

.01

Life

sta

tus

dat

eLi

fe s

tatu

s d

ate

(dd

/mm

/yyy

y)D

ate

(dd

/mm

/yyy

y)

517

.02

Life

sta

tus

11.

Aliv

eTe

xt (s

ingl

e va

lue)

22.

Dea

d

517

.03

Dea

th (r

easo

n)1

1. S

udd

enTe

xt (s

ingl

e va

lue)

22.

Wor

seni

ng H

F

33.

Oth

er C

V

44.

Non

CV

517

.04

Dea

th (I

nfo

Sou

rce)

1

1. A

utop

syTe

xt (s

ingl

e va

lue)

22.

Dea

th C

ertifi

cate

33.

ON

S

44.

Hos

pita

l rec

ord

s

55.

G.P

rec

ord

s

66.

Ver

bal

con

trac

t

99.

Oth

er

NATIONAL HEART FAILURE AUDIT Application NotesDataset version 3. Valid from 26th March 2012

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