NATIONAL HEART
FAILURE AUDIT
Application Notes
Dataset version 3
Valid from 26th March 2012
Contents
Contents
1
Introduction_______________________________________________________________________________________________________3
2
Contact details____________________________________________________________________________________________________4
3
Data collection____________________________________________________________________________________________________5
4
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
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
Core dataset definitions__________________________________________________________________________________________ 11
5.1
Patient record______________________________________________________________________________________________ 11
5.2Admission/readmission_____________________________________________________________________________________ 11
5.2.1 Admission and symptoms____________________________________________________________________________ 11
5.2.2 History_____________________________________________________________________________________________ 12
5.2.3 Physical examination_________________________________________________________________________________ 12
5.2.4Investigations_______________________________________________________________________________________ 12
5.2.5 Treatment on discharge_______________________________________________________________________________ 13
5.2.6Diagnosis___________________________________________________________________________________________ 14
5.2.7Discharge___________________________________________________________________________________________ 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
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 1
Contents
2 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Introduction & contact details
1Introduction
The National Heart Failure Audit was established in 2007 with the
In 2010/11 85% of all Trusts in England and Wales submitted
aim of collecting and disseminating national comparative data
data on 54% of all patients discharged from hospital with a
on the diagnosis, treatment and management of heart failure
primary diagnosis of heart failure (compared with HES data).
patients in secondary care. National clinical audit data is reported
Building on this foundation, the audit hopes to include data from
to hospitals and Trusts, Cardiac Networks and NHS regulatory
90% of Trusts by 2011/12, which will not be possible without the
bodies in order to drive the improvement of heart failure services
continued support and participation of hospitals across the UK.
and to achieve better outcomes for patients.
We are very grateful to all of our colleagues who have submitted
The National Heart Failure Audit is managed by NICOR (the
National Institute for Cardiovascular Outcomes Research), which
data and taken part in the audit over the last 5 years.
This document details a revised dataset, version 3, which came
is based in the Institute of Cardiovascular Science at University
into effect on 26th March 2012, and which replaces the existing
College London. NICOR manages seven national cardiac clinical
version 2 of the dataset. The new dataset contains a series of
audits. Specialist clinical knowledge and clinical leadership for
additional data items that will allow the audit to monitor the
the National Heart Failure Audit is provided by the British Society
implementation of the NICE quality standard for chronic heart
of Heart Failure and the audit Project Board, which determines
failure which was published last year. Additional fields will also
the strategic direction and development of the project, and which
enable the risk adjustment of data, which is necessary for the
includes stakeholders from hospitals, Cardiac Networks and
development of accurate comparative mortality analysis. The
patient groups.
aim of the revision is firstly to facilitate more comprehensive
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
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.
that are used by regulatory bodies such as the Care Quality
Commission and the NHS Information Centre to measure
performance of NHS organisations.
1http://www.hqip.org.uk/national-clinical-audit-and-patient-outcomes-programme.
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 3
Introduction & contact details
2 Contact details
Clinical queries
General enquiries
The National Heart Failure Audit provides a helpdesk during
National Heart Failure Audit
working hours for all clinical queries and general enquiries about
NICOR, 3rd Floor, 170 Tottenham Court Road, London W1T 7HA
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:enquiries-nicor@ucl.ac.uk
Tel:
020 3108 3929
Email:polly.mitchell@ucl.ac.uk
Tel:
020 3108 3927
Technical queries
All technical enquiries concerning Lotus Notes or any other IT
issues should be directed to the NICOR helpdesk.
Email:nicor-helpdesk@ucl.ac.uk
Tel:
020 3108 1978
4 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Data collection
3 Data collection
3.1 Which patients to include
The audit collects data on all patients discharged from hospital
3.4 Patient confidentiality
and identification
with a diagnosis of heart failure in the primary position (the main
The National Heart Failure Audit collects patient identifiable data
condition treated or investigated during the episode of care) for
in order to track life status by linkage with MRIS mortality data,
the following ICD-10 codes:2
and to enable linkage with the other cardiac databases, such
I50.0 Congestive heart failure
as MINAP (Myocardial Ischaemia National Audit Project) and
CRM (Cardiac Rhythm Management). However, there are strict
I50.1 Left ventricular failure
rules for the use of potential patient identifiers; although patient
I50.9 Heart failure, unspecified
identifiers are entered into the National Heart Failure Audit, these
I11.0 Hypertensive heart disease with (congestive) heart
failure
can only be seen by staff at your own hospital with access to
the database, and by specific NICOR staff who manage the
database.
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
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
database for local auditing, but as yet their data will not be
number) are pseudonymised. This is done using an encryption
included in the audit.
key that the third party using the data does not have access
to, which means that they cannot convert the details back to
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
their original, identifiable form.
„„ Date of birth is converted to age at admission.
„„ Postcode can be an identifier where small numbers of
each Trust submitting a minimum of 20 cases per month to
individuals share a post code in rural areas. Postcode is
the database. If a Trust discharges fewer than 20 heart failure
used to derive dependant variables such as Index of Multiple
patients in a month, the total number of cases should be
Deprivation (England only), and only these derived fields are
submitted. The percentage of the overall heart failure patient
available for secondary use.
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
„„ Hospital identifier is also pseudonymised, so that third parties
outside of NICOR cannot undertake identifiable hospitalspecific analysis.
month, count towards the monthly total of cases submitted.
3.3 Ensuring representativeness
3.5 Patient consent
NICOR has section 251 approval from the NIGB, which allows
Because the National Heart Failure Audit does not require you
it to collect and process patient identifiable data for all of the
to enter all of the heart failure patients discharged from your
cardiovascular audits, including the National Heart Failure Audit,
hospital, it is essential that the patient sample entered into
without requiring consent. However we recommend that you tell
the audit is representative of your overall heart failure patient
patients that their anonymised data will be used for national audit
population. The most effective way of ensuring this is to enter
and research purposes to improve patient care.
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
A patient leaflet, along with more information about NICOR, is
available on the NICOR website.3
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.
3http://www.ucl.ac.uk/nicor/audits.
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 5
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.
‘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
3.7 Use of National Heart Failure
Audit data
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
Participation in the National Heart Failure Audit has been
to ensure that the data entered is not contradictory and is within
mandated by the NHS standard contracts for acute hospital
permitted ranges, but those responsible for entering data need to
services.6 Audit data are used by increasing numbers of groups
monitor the quality of their data entry on top of this. Hospitals are
outside of your hospital which have a legitimate interest in the
bound by the Data Protection Act 1998 to ensure that the data
analysis. These include:
should meet the necessary standards of completeness, accuracy
Indicators for quality improvement: The NHS Information
and relevance.
Centre and the Department of Health have identified an initial, but
You should register the National Heart Failure Audit with your
evolving, set of ‘Indicators for Quality Improvement’ to describe
Trust data protection officer, and identify someone in your
the quality of a broad range of healthcare services.7
hospital with overall responsibility for the audit. One person
These indicators include participation in the Heart Failure Audit,
should be given overall responsibility for data collection, with
which is defined as a Trust submitting 20 patient admissions per
month to the National Heart Failure Audit between 01/04/2010
additional clinical support if needed. Backup support must be
identified for periods of leave; it is the responsibility of your Trust
and 31/03/2011.8
to support you in this.
The NHS Choices website also includes details of participation in
Current data collection manuals with definitions should be made
the audit in its ‘scorecard’ for Trust performance.
available to all staff involved in data collection and entry, and data
Care Quality Commission Quality Risk profiles:9 The QRP is
has been discharged to ensure the greatest possible accuracy.
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
should ideally be entered as soon as possible after the patient
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
keen to use further data in future.
The audit year runs from 1st April to 31st March. Unless
Transparency agenda: Clinical audit was one of six key areas
otherwise stated, all data for the financial year must be uploaded
raised under the heading ‘NHS’ in the Prime Minister’s Letter to
Cabinet Ministers on transparency and open data which stated:
4www.ucl.ac.uk/nicor/audits/heartfailure/datacollection.
5www.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.
7http://www.ic.nhs.uk/services/measuring-for-quality-improvement.
8https://mqi.ic.nhs.uk/Search.aspx?query=heart%25failure&ref=1.05.27.
9http://www.cqc.org.uk/organisations-we-regulate/registered-services/quality-and-riskprofiles-qrps.
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.
10http://www.number10.gov.uk/news/letter-to-cabinet-ministers-on-transparency-andopen-data/.
6 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
The dataset
4 The dataset
The National Heart Failure Audit database now contains over
47 of the 59 fields are now mandatory, i.e. data items that must
125,000 records of patients discharged from hospital with a
be filled in for the record to be saved. Most mandatory fields
diagnosis of heart failure. This large amount of data can be used
(apart from basic patient data) have an ‘unknown’ option, so if
to monitor trends in the management of heart failure patients and
you are unable to obtain some data items the record can still
to determine key clinical indictors for heart failure patients.
be saved. Those core items that are not mandatory are mainly
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.
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
With the audit now collecting a substantial amount of data each
locally developed applications to import data stored on local
year, it will be possible to analyse outcome data at the level of
databases must ensure that these are updated to include all of
individual Trusts, in addition to national, aggregate analyses. In
the modifications in the revised dataset. Commercial software
order to do this, it is necessary to risk adjust the data for known
companies have been notified of the changes, but check with
confounders – certain factors, such as age, index of multiple
your provider if in doubt. If your software is locally developed,
deprivation and medical history, have a large impact on morbidity
you will need to update the locally held options dictionary.
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.
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.
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.
12www.ucl.ac.uk/nicor/audits/heartfailure/dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 7
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.
#
4.07
Field description
Previous device therapy
(M)
4.17
Previous COPD(M)
Short code
Long code
Field Type
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)
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)
1
1. Yes
Text (single value)
8
8. Not applicable
Text (single value)
9
9. Unknown
Text (single value)
12
12. Declined by patient
Text (single value)
1
1. A heart failure pre-discharge management plan is in
Text (single value)
15.11
Discharge planning (M)
place
NB: 15.11 was previously
a multivalue text field, and
is now a single value text
2
2. A heart-failure management plan has been discussed
Text (single value)
with the patient
field.
3
3. A heart failure management plan has been
Text (single value)
communicated to the primary care team
4
4. All of the above
Text (single value)
5
5. None of the above
Text (single value)
9
9. Unknown
Text (single value)
8 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
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
Field description
Long code
Field Type
0
0. No
Text (single value)
1
1. Yes
Text (single value)
(M)
9
9. Unknown
Text (single value)
Which of the following did
1
1. Consultant cardiologist
Text (multivalue;
Did the patient
receive input from a
multidisciplinary HF team?
2.04ai
Short code
the patient see? (M)
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
7.40
Previous Asthma (M)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
9
9. Unknown
Text (single value)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
9
9. Unknown
Text (single value)
Ivabradine dose
Numeric (real)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
9
9. Unknown
Text (single value)
Treatment ivabradine dose
Numeric (real)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
made? (M)
9
9. Unknown
Text (single value)
Date of HF review
Date of review appointment
Date (dd/mm/yyyy)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
9
9. Unknown
Text (single value)
0
0. No
Text (single value)
1
1. Yes
Text (single value)
Ivabradine (non-core)
7.41
Ivabradine dose (non-core)
11.40
Treatment ivabradine (noncore)
11.41
Treatment ivabradine dose
(non-core)
15.12
Was a review appointment
with the specialist
multidisciplinary HF team
15.13
appointment
15.14
Was the patient stable
on oral therapy after
discharge planning? (M)
15.15
Patient died? (M)
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 9
The dataset
4.4 New options within fields
The following data items are additional options added to existing mandatory fields.
#
11.01
11.04
11.06
11.09
11.11
11.13
11.20
15.01
15.05
Field description
Treatment ACE inhibitor
Treatment ARB
Treatment beta blocker
Treatment loop diuretic
Treatment thiazide diuretic
Treatment ARA
Treatment digoxin
Cardiac rehabilitation
Palliative care
Short code
Long code
Field Type
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
5
5. Other loop diuretic
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
8
8. Not applicable
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
3
3. Other ARA
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
8
8. Not applicable
Text (single value)
11
11. Contraindicated
Text (single value)
12
12. Declined by patient
Text (single value)
8
8. Not applicable
Text (single value)
12
12. Declined by patient
Text (single value)
8
8. Not applicable
Text (single value)
4.5 Deleted fields
#
8.12
Field description
Peripheral Oedema
Short code
Long code
Field Type
0
0. No
Text (single value)
1
1. Yes
Text (single value)
9
9. Unknown
Text (single value)
10 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Core dataset definitions
5 Core dataset definitions
The core dataset contains 59 fields, 47 of which are mandatory,
Birth date (1.06) Date of birth is crucial for verifying mortality
i.e. the record will not be saved without them. If you cannot find
data and identifying missing NHS numbers. It is also used for risk
the relevant information needed to satisfy mandatory core data
adjustment and to measure potential inequalities in access to care,
items in the patient’s notes, you should use the “Unknown”
and to monitor changes in patient demographics.
option.
A patient must be over 16 years of age to be entered into the
In the list below, † denotes non-mandatory, core fields. Although
heart failure database. Date of birth should be in the format dd/
you can save a record without these fields, you are encouraged
mm/yyyy.
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
Patient gender (1.07) Patient gender is used to measure
potential inequalities in access to care, and to monitor changes in
patient demographics.
the patient died in hospital, the fields relating to treatment on
Postcode (1.09) This is the postcode nominated by the patient
discharge and referral to follow-up services are not mandatory.
as their main permanent residence. Pseudo postcodes should
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.
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.
5.2Admission/readmission
Once you have created a patient record you can add an
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
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
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.
fields are divided into the following sub-headings: Admission
and Symptoms, History, Physical Examination, Investigations,
Treatment on Discharge, Diagnosis, Discharge, and User Defined
Fields.
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
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
patients as possible have their NHS number entered accurately.
comfortable at rest. Ordinary physical activity results in
Patient name (surname) (1.04) The patient’s name is used for
fatigue, palpitation, breathlessness or angina pectoris (NYHA
mortality tracking in the instance that there is a discrepancy
between any of the other patient identifiers, or if the NHS number
Class II).
3. Marked limitation of ordinary physical activity: Although
is missing.
patients are comfortable at rest, less than ordinary activity will
Patient name (forename) (1.05)
lead to symptoms (NYHA Class III).
13 http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/.
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 11
Core dataset definitions
4. Symptoms at rest or minimal activity: Symptoms of congestive
mandatory fields, but are important for risk adjusting mortality
cardiac failure are present even at rest. Increased discomfort
and for morbidity analysis. Height and weight are used to
with any physical activity (NYHA Class IV).
calculate patient BMI.
5.2.2History
5.2.4 Investigations
Previous IHD (4.00) Does the patient have history of myocardial
For all investigations, if multiple tests were performed the results
infarction (MI), angina, ECG evidence of MI, CABG or angiogram
of the last test should be recorded. For all blood tests and QRS
documenting coronary artery disease?
duration, leave blank if test was not done or the result is not
Previous AMI (4.01) Has the patient had a previously validated
known.
episode of acute myocardial infarction (MI), including ECG
Hb (9.01)† A record of the patient’s haemoglobin level in grams
evidence of MI (for example Q-waves on admission)?
per decilitre (g/dL).
Previous valve disease (4.09) Does the patient have a history of
Urea (9.02)† A record of the patient’s urea level in milligrams per
clinically diagnosed valve disease, moderate or severe stenosis
decilitre (mg/dL).
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
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).
with diabetes prior to admission? This could include any
NB: The above blood tests are not mandatory fields, but these
of: a confirmed diagnosis of diabetes, the use of an oral
measurements are a NICE recommended diagnostic tool for heart
hypoglycaemic agent or insulin, a fasting blood glucose >6.7, or
failure, so it is recommended that these tests are both performed
a random blood glucose >11 mmol/L.
and subsequently recorded in the audit.
Previous asthma (4.14a) Does the patient have a history of
BNP (9.13)† A record of the patient’s B-type Natriuretic Peptide
asthma? This can be a previous clinical diagnosis or known
(BNP) level in picograms per millilitre (pg/mL).
significant reversible airways obstruction.
BNP is not a mandatory field, but the measurement of BNP
Previous COPD (4.17) Does the patient have a history of COPD
is a NICE quality standard for chronic heart failure, so it is
(chronic obstructive pulmonary disease), including chronic
recommended that BNP level is measured and recorded in the
bronchitis, emphysema or their co-occurrence? Must be
audit.
indicated by pulmonary function testing evidence i.e. FEV1<75%
QRS Duration (9.16)† The QRS duration in milliseconds (ms), if
predicted value or use of beta agonist/steroid inhalers.
known. QRS Duration is not a mandatory field, but if an ECG was
performed then QRS duration should be known.
5.2.3 Physical examination
ECG (9.21) Was an electrocardiogram was performed during this
Peripheral Oedema (3.04) Did the patient exhibit ankle or sacral
admission, and if so, what did it show? If not done, has an ECG
oedema on admission?
been planned? ECG is recommended as a diagnostic test in the
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
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
12 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Core dataset definitions
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
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
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
3. Lisinopril
4. Perindopril
5. Ramipril
hypertrophy reported on an imaging test (for example, LV
6. Trandolapril
posterior wall dimension in diastole >1.3cm and/or septal
7. Other ACEI
dimension >1.3cm).
Treatment ARB (11.04) Was the patient prescribed angiotensin
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
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?
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
1. Bisoprolol
2.Carvedilol
3. Nebivolol
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.
4. Other beta blocker
Treatment loop diuretic (11.09) Was the patient prescribed loop
diuretics on discharge?
Multiple options can be selected but note that 0, 6, 7, and 9
cannot be selected in combination with any other values.
1. Bumetanide
2. Ethancrynic acid
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
3. Furosemide
4. Torasemide
5. Other loop diuretic
levels, so if the dose is known you are encouraged to enter it.
Treatment thiazide diuretic (11.11) Was the patient prescribed
Dose refers to total daily dose.
thiazide diuretics on discharge?
For all treatment on discharge fields:
1. Bendroflumethazide
8. Not applicable: The use of the treatment was not indicated
2. Metolazone
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.
3. Other thiazide
Treatment ARA (11.13) Was the patient prescribed aldosterone
receptor antagonists (ARAs) on discharge?
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 13
Core dataset definitions
1. Eplerenone
2. Spironolactone
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
3. Other ARA
staff. Treatment by specialists is a key clinical indicator for heart
Previous device therapy (4.07) Has the patient had device
failure patients.
therapy either during this admission or at a previous time?
1. Consultant cardiologist
1. CRT-D: The patient has been referred for a cardiac
2. Other consultant with interest in heart failure: This may be a
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.
5.2.6Diagnosis
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.
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
5.2.7Discharge
cardiac rehabilitation programme? Cardiac rehab usually involves
an exercise-based programme that includes educational and
Some fields referring to discharge instructions and follow-up
psychological support, but can occur without an exercise
services are not mandatory if the patient died in hospital.15
component if the patient cannot tolerate exercise.
Main place of care (2.04) In your opinion, the ward in which
The NICE quality standard for chronic heart failure recommends
the patient received the majority of their care. “3. Other” will in
that people with stable chronic heart failure and no precluding
many cases be a geriatrics ward. Being admitted to a cardiology
condition or device are offered a supervised group exercise-
ward is a key determinant of good care and treatment for patient,
based cardiac rehabilitation programme that includes education
which results in reduced morbidity and mortality rates.
and psychological support.
Did the patient receive input from a multidisciplinary HF
Palliative care (15.05) Were the palliative care services involved
team? (2.04a) Did the patient receive input from any member of
or planned for on discharge?
the multidisciplinary heart failure team during this admission?
COTE/medical follow up (15.06) Was the patient referred to
A multidisciplinary heart failure team is led by a specialist and
follow-up in a geriatric or general medical ward, or were care of
consists of professionals with appropriate competencies from
the elderly (COTE) services involved or planned for on discharge?
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
Cardiology follow up (15.07) Was the patient referred for followup 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
The input of a multidisciplinary heart failure team is
discharged, transferred to another hospital, or the date of death
recommended by NICE quality standard for chronic heart failure.
if patient died in hospital. Date should be in the format dd/mm/
Which of the following did the patient see? (2.04ai) Which
yyyy.
This is required to measure length of stay which is a key patient
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.
outcome for the audit.
14 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Core dataset definitions
Discharge planning (15.11)
Did the patient die? (15.15) Did the patient die during this
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
admission? If the patient died, fields referring to follow-up care
and treatment on discharge are not mandatory.
5.2.8 User defined fields
discussion of the stability of the patient’s clinical condition, and
For local audit purposes, data can be collected on fields not
may take into account patient and carer wishes, and the level of
included in the audit. The full dataset has 242 items, so much of
care and support that can be provided in the community.
the data relevant to heart failure patients can be collected using
NICE quality standard for chronic heart failure recommends
existing fields.
that people admitted to hospital because of heart failure have a
You can add user defined fields by going to the “Settings” link in
personalised management plan that is shared with them, their
the left navigator of Lotus Notes. Choose “Hospitals”, find your
carer(s) and their GP.
hospital and double click it. Select the “User Defined Fields” tab
1. A heart failure pre-discharge management plan is in place
and double click next to “Field 1” to add a new field description.
2. A heart-failure management plan has been discussed with the
patient
These descriptions will now appear as free text fields in the “User
Defined Fields” section of each admission and readmission you
create.
3. A heart failure management plan has been communicated to
the primary care team
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.
4. All of the above
5. None of the above
5.3 Unscheduled event
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?
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.
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.
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)
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.
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.
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
Life status date (17.01)
Life status (17.02)
failure and with stable renal function?
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 15
Core dataset definitions
16 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
NICE quality standard 1119: People admitted to hospital because of heart failure receive input to their management plan from a
multidisciplinary heart failure team.
Local patient identifier
NHS number
Patient name (Surname)
Patient name (Forename)
Birth date
Patient gender
Postcode
Date of admission
Main place of care
Did the patient receive input from a
multidisciplinary HF team?
1.03
1.04
1.05
1.06
1.07
1.09
2.00
2.04
2.04a
17 Department of Health, 2011/12 Standard Terms and Conditions for Acute Hospital Services (Gateway Reference 15458), Clause 12.1.2, http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124518.pdf.
18ICE, Chronic heart failure (CG108) (2010), http://publications.nice.org.uk/chronic-heart-failure-cg108/guidance.
19NICE, Chronic heart failure quality standard (2011), http://www.nice.org.uk/guidance/qualitystandards/chronicheartfailure/home.jsp.
healthcare community.
NICE CG108, 1.5.3.1: Heart failure care should be delivered by a multidisciplinary team with an integrated approach across the
„„ heart failure that can no longer be managed effectively in the home setting.
„„ heart failure that does not respond to treatment
„„ severe heart failure (NYHA class IV)
and the management of:
NICE CG108, 1.1.1.4: Refer patients to the specialist multidisciplinary heart failure team for the initial diagnosis of heart failure
Used to establish whether access to key diagnostics, clinical treatment and follow up care is determined by ward of admission.
Used to calculate length of stay. Also used to establish correct cohort of patients and measure year on year improvements in care.
Numbers. Derived data, such as PCT and multiple index of deprivation, are used for analysis.
Full postcode is crucial for MRIS list cleaning purposes, to allow us to link to mortality data and to discover missing NHS
NICE CG108, 1.2.2.3018: The principles of pharmacological management of heart failure should be the same for men and women.
onset in women.
Patient gender is used to measure potential inequalities in access to care, and to monitor changes in patient demographics e.g.
also used for risk adjustment, to measure potential inequalities in access to care, and to monitor changes in patient demographics.
Date of birth is crucial for MRIS list cleaning purposes, and allows us get mortality data and to discover missing NHS numbers. It is
name also enables analysis by birth cohort and assists linkage at MRIS/NHSCR.
Collecting the patient’s name enables age at diagnosis to be established for epidemiological and survival analysis. The patient’s
encrypted before data transfer. Any other event or procedure recorded by NICOR will be linked using the NHS number.
The patient’s NHS number is the unique national identifier that will be used for event and mortality tracking. This will be
quality of follow up care.
multiple entries and to categorise readmissions. Readmissions are a key outcome measure and used as an indicator of the
A hospital number is used to identify patients if the NHS number is not known. Local patient identifiers are also used to identify
clinical audits within the National Clinical Audit Patients Outcome Programme (NCAPOP) relevant to the Services.
1.02
2011/12 Standard Terms and Conditions for Acute Hospital Services, 12.1.217: The provider shall participate in the national
Justification
Hospital identifier
Field Description
1.01
Sequence
Number
The following table shows the core dataset items mapped to the NICE clinical guideline and quality standard for chronic heart failure, or otherwise explains why the audit collects each data item.
6 Clinical guidelines
Clinical guidelines
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 17
Which of the following did the patient see?
Breathlessness
Peripheral oedema
Previous IHD
Previous AMI
Previous valve disease
Previous hypertension
Previous diabetes
Previous asthma
Previous COPD
Height
Weight
Heart rate
Blood pressure - systolic
Hb
Urea
Creatinine
Electrolytes: Sodium (Na)
Electrolytes: Potassium (K)
BNP
QRS Duration
ECG
3.01
3.04
4.00
4.01
4.09
4.12
4.14
4.14a
4.17
8.01
8.02
8.04
8.06
9.01
9.02
9.03
9.04
9.05
9.13
9.16
9.21
Field Description
2.04ai
Sequence
Number
18 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
NICE CG108, 1.1.1.13: Perform an ECG…to evaluate possible aggravating factors and/or alternative diagnoses.
have their serum natriuretic peptides measured.
NICE quality standard 2: People presenting in primary care with suspected heart failure without previous myocardial infarction
peptide [NTproBNP]) in patients with suspected heart failure without previous MI.
NICE CG108, 1.1.1.3: Measure serum natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro-B-type natriuretic
„„ full blood count
„„ electrolytes, urea and creatinine
diagnoses:
NICE CG108, 1.1.1.13: Consider the following [blood] tests to evaluate possible aggravating factors and/or alternative
Required for developing risk adjusted data e.g. mortality.
Required for developing risk adjusted data e.g. mortality.
Needed to calculate BMI, which is required for developing risk adjusted data e.g. mortality.
Symptoms, NYHA class and previous medical history are all used in risk adjustment of data.
NICE CG108, 1.1.1.1: Take a detailed history and perform a clinical examination. This includes severity of HF.
multidisciplinary heart failure team.
NICE quality standard 11: People admitted to hospital because of heart failure receive input to their management plan from a
Used to establish whether treatment by specialists has an effect on diagnostics, treatment, outcomes and follow up care.
Justification
Clinical guidelines
Treatment ACE inhibitor
Treatment ARB
11.04
transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks.
the optimal tolerated or target dose with monitoring after each increase.
with angiotensin-converting enzyme inhibitors) and beta-blockers licensed for heart failure, which are gradually increased up to
converting enzyme inhibitors (or angiotensin II receptor antagonists licensed for heart failure if there are intolerable side effects
NICE quality standard 7: People with chronic heart failure due to left ventricular systolic dysfunction are offered angiotensin-
failure due to left ventricular systolic dysfunction who have intolerable side effects with ACE inhibitors.
NICE CG108, 1.2.2.14: Consider an ARB licensed for heart failure as an alternative to an ACE inhibitor for patients with heart
[NYHA class II–III]).
an angiotensin II receptor antagonist (ARB) licensed for heart failure (especially if the patient has mild to moderate heart failure
optimal therapy with an ACE inhibitor and a beta-blocker:
NICE CG108, 1.2.2.4: Seek specialist advice and consider adding one of the following if a patient remains symptomatic despite
the optimal tolerated or target dose with monitoring after each increase.
with angiotensin-converting enzyme inhibitors) and beta-blockers licensed for heart failure, which are gradually increased up to
converting enzyme inhibitors (or angiotensin II receptor antagonists licensed for heart failure if there are intolerable side effects
NICE quality standard 7: People with chronic heart failure due to left ventricular systolic dysfunction are offered angiotensin-
start first.
to all patients with heart failure due to left ventricular systolic dysfunction. Use clinical judgement when deciding which drug to
NICE CG108, 1.2.2.2: Offer both angiotensin-converting enzyme (ACE) inhibitors and beta-blockers licensed for heart failure
referral.
failure and intermediate serum natriuretic peptide levels are seen by a specialist and have an echocardiogram within 6 weeks of
NICE quality standard 4: People referred for specialist assessment including echocardiography because of suspected heart
a specialist and have an echocardiogram within 2 weeks of referral.
heart failure and previous myocardial infarction or suspected heart failure and high serum natriuretic peptide levels, are seen by
NICE quality standard 3: People referred for specialist assessment including echocardiography, either because of suspected
transthoracic Doppler 2D echocardiography.
magnetic resonance imaging or transoesophageal Doppler 2D echocardiography) when a poor image is produced by
NICE CG108, 1.1.1.10: Consider alternative methods of imaging the heart (for example, radionuclide angiography, cardiac
systolic (and diastolic) function of the (left) ventricle, and detect intracardiac shunts.
NICE CG108, 1.1.1.7: Perform transthoracic Doppler 2D echocardiography to exclude important valve disease, assess the
and specialist assessment within 6 weeks.
litre) or an NTproBNP level between 400 and 2000 pg/ml (47–236 pmol/litre) to have transthoracic Doppler 2D echocardiography
NICE CG108, 1.1.1.5: Refer patients with suspected heart failure and a BNP level between 100 and 400 pg/ml (29–116 pmol/
litre) urgently, to have transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks.
suspected heart failure and a BNP level above 400 pg/ml (116 pmol/litre) or an NTproBNP level above 2000 pg/ml (236 pmol/
NICE CG108, 1.1.1.4: Because very high levels of serum natriuretic peptides carry a poor prognosis, refer patients with
NICE CG108, 1.1.1.2: Refer patients with suspected heart failure and previous myocardial infarction (MI) urgently, to have
Nuclear Scan or Angiogram)
Justification
ECHO (or other gold standard test e.g. MRI,
Field Description
11.01
9.23
Sequence
Number
Clinical guidelines
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 19
Treatment beta blocker
Treatment loop diuretic
Treatment thiazide diuretic
Treatment ARA
Treatment digoxin
Treatment device therapy
Diagnosis of heart failure
HF liaison service
Cardiac rehabilitation
11.09
11.11
11.13
11.20
12.01
14.00
15.00
15.01
Field Description
11.06
Sequence
Number
20 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
group exercise-based cardiac rehabilitation programme that includes education and psychological support.
NICE quality standard 8: People with stable chronic heart failure and no precluding condition or device are offered a supervised
The programme may be incorporated within an existing cardiac rehabilitation programme.
Include a psychological and educational component in the programme.
Ensure the patient is stable and does not have a condition or device that would preclude an exercise-based rehabilitation programme.
NICE CG108, 1.3.1.1: Offer a supervised group exercise-based rehabilitation programme designed for patients with heart failure.
assessment by a multidisciplinary heart failure team within 2 weeks of discharge.
NICE quality standard 12: People admitted to hospital for heart failure are discharged only when stable and receive a clinical
including a review of medication and measurement of renal function.
NICE quality standard 9: People with stable chronic heart failure receive a clinical assessment at least every 6 months,
confirmed should be managed in accordance with this guideline.
NICE CG108, 1.1.2.1: The basis for historical diagnosis of heart failure should be reviewed, and only patients whose diagnosis is
despite first- and second-line treatment for heart failure.
NICE CG108, 1.2.2.16: Digoxin is recommended for worsening or severe heart failure due to left ventricular systolic dysfunction
III–IV] or has had an MI within the past month).
an aldosterone antagonist licensed for heart failure (especially if the patient has moderate to severe heart failure [NYHA class
optimal therapy with an ACE inhibitor and a beta-blocker:
NICE CG108, 1.2.2.4: Seek specialist advice and consider adding one of the following if a patient remains symptomatic despite
with heart failure, and titrated (up and down) according to need following the initiation of subsequent heart failure therapies.
NICE CG108, 1.2.2.17: Diuretics should be routinely used for the relief of congestive symptoms and fluid retention in patients
the optimal tolerated or target dose with monitoring after each increase.
with angiotensin-converting enzyme inhibitors) and beta-blockers licensed for heart failure, which are gradually increased up to
converting enzyme inhibitors (or angiotensin II receptor antagonists licensed for heart failure if there are intolerable side effects
NICE quality standard 7: People with chronic heart failure due to left ventricular systolic dysfunction are offered angiotensin-
„„ chronic obstructive pulmonary disease (COPD) without reversibility.
„„ interstitial pulmonary disease and
„„ diabetes mellitus
„„ erectile dysfunction
„„ peripheral vascular disease
dysfunction, including older adults and patients with:
NICE CG108, 1.2.2.7: Offer beta-blockers licensed for heart failure to all patients with heart failure due to left ventricular systolic
patients with heart failure due to left ventricular systolic dysfunction. Use clinical judgement when deciding which drug to start first.
NICE CG108, 1.2.2.2: Offer both angiotensin-converting enzyme (ACE) inhibitors and beta-blockers licensed for heart failure to all
Justification
Clinical guidelines
NICE CG108, 1.1.1.4: Refer patients to the specialist multidisciplinary heart failure team for the initial diagnosis of heart failure
and the management of:
COTE/medical follow up
Cardiology follow up
GP
Date of discharge
Discharge planning
Was a review appointment with the specialist
multidisciplinary HF team made?
15.07
15.08
15.10
15.11
15.12
discharge planning?
Patient died
assessment by a multidisciplinary heart failure team within 2 weeks of discharge.
Was the patient stable on oral therapy after
15.14
15.15
NICE quality standard 12: People admitted to hospital for heart failure are discharged only when stable and receive a clinical
Date of heart failure review appointment
15.13
assessment by a multidisciplinary heart failure team within 2 weeks of discharge.
NICE quality standard 12: People admitted to hospital for heart failure are discharged only when stable and receive a clinical
healthcare community.
NICE CG108, 1.5.3.1: Heart failure care should be delivered by a multidisciplinary team with an integrated approach across the
„„ heart failure that can no longer be managed effectively in the home setting.
„„ heart failure that does not respond to treatment
„„ severe heart failure (NYHA class IV)
shared with them, their carer(s) and their GP.
NICE quality standard 10: People admitted to hospital because of heart failure have a personalised management plan that is
NICE CG108, 1.5.2.2: The primary care team, patient and carer must be aware of the management plan.
level of care and support that can be provided in the community.
is stable and the management plan is optimised. Timing of discharge should take into account patient and carer wishes, and the
NICE CG108, 1.5.2.1: Patients with heart failure should generally be discharged from hospital only when their clinical condition
Used to calculate length of stay and to calculate audit participation rates.
including a review of medication and measurement of renal function.
NICE quality standard 9: People with stable chronic heart failure receive a clinical assessment at least every 6 months,
assessment by a multidisciplinary heart failure team within 2 weeks of discharge.
NICE quality standard 12: People admitted to hospital for heart failure are discharged only when stable and receive a clinical
including a review of medication and measurement of renal function.
NICE quality standard 9: People with stable chronic heart failure receive a clinical assessment at least every 6 months,
including a review of medication and measurement of renal function.
NICE quality standard 9: People with stable chronic heart failure receive a clinical assessment at least every 6 months,
heart failure and a palliative care service.
NICE quality standard 13: People with moderate to severe chronic heart failure, and their carer(s), have access to a specialist in
within the heart failure team.
NICE CG108, 1.5.9.3: Patients with heart failure and their carers should have access to professionals with palliative care skills
15.06
NICE CG108, 1.5.9.2: The palliative needs of patients and carers should be identified, assessed and managed at the earliest opportunity.
Justification
Palliative care
Field Description
15.05
Sequence
Number
Clinical guidelines
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 21
National Heart Failure Audit pro forma
7
National Heart Failure Audit pro forma (dataset version 3)
Patient Record
Hospital
Valid from 26/03/12
Hospital #
Forename
NHS #
Surname
Date of birth
/
/
Postcode
Sex
Admission and Symptoms
History
Admission date
/
/
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
[Heart rate, blood pressure, oedema on admission; height & weight at last available
recording]
Peripheral Oedema
Height (cm)
0. No
Weight (kg)
1. Mild
Heart rate (bpm)
2. Moderate Systolic blood pressure
3. Severe
9. Unknown Investigations [Last available recording]
ECG (current/previous admission)
Blood tests
[More than one value can be selected]
BNP
1. Sinus rhythm
Hb
2. Atrial fibrillation
Urea
3. LBBB
Creatinine
4. Previous MI
Electrolytes-NA
6. Not done - planned after discharge
Electrolytes-K
7. Not done - not yet planned
8. Other
9. Unknown
QRS width Treatment on discharge
ARB
Beta blocker
Loop diuretic
0. No
0. No
0. No
1. Candesartan
1. Bisoprolol
1. Bumetanide
2. Losartan
2. Cardvedilol
2. Ethancrynic acid
3. Valsartan
3. Nebivolol
3. Frusemide
4. Other ARB
4. Other beta blocker
4. Torasemide
8. Not applicable
8. Not applicable
5. Other loop diuretic
9. Unknown
9. Unknown
8. Not applicable
10. Drug therapy
9. Unknown
10. Drug therapy stopped
stopped
11. Contraindicated
11. Contraindicated
10. Drug therapy stopped
12. Declined by patient
12. Declined by patient
11. Contraindicated
12. Declined by patient
Male / Female
0. No
Diagnosis
1. Yes
9.Unknown
Confirmed diagnosis of heart failure?
0. No
1. Yes
9. Unknown
ECHO (or other gold standard test)
e.g MRI,Nuclear Scan or Angio
[More than one value can be selected]
0. Normal
1. LV systolic dysfunction 2. LV hypertrophy
3. Valve disease
4. Diastolic Dysfunction
6. Not done - planned after discharge
7. Not done - not yet planned
8. Other
9.Unknown
ARA
0. No
1. Eplerenone
2. Spironolactone
3. Other ARA
8. Not applicable
9. Unknown
10. Drug therapy stopped 12. Declined by patient
22 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
National Heart Failure Audit pro forma
7
National Heart Failure Audit pro forma (dataset version 3)
Valid from 26/03/12
Treatment on discharge (cont.)
ACE Inhibitor
Digoxin
Thiazide diuretic
0. No
1. Captopril
2. Enalapril
3. Lisinopril
4. Perindopril
5. Ramipril
6. Trandolapril
7. Other ACEI
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
Discharge
Date of discharge
0. No
1. Yes
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
0. No
1. Bendroflumethazide
2. Metolazone
3. Other thiazide
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
/
/
Referral to services
Previous device therapy?
0. None
1. CRT-D
2. CRT-P
3. ICD
4. PM
12. Declined by patient
Did the patient die during this
Yes / No
admission?
[If yes, fields relating to treatment on discharge and followup 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
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 23
Sequence
Number
1.01
1.02
1.03
1.04
1.05
1.06
1.07
1.09
2.00
2.04
2.04a
2.04ai
1,2,3,4,54
1,2,3,4,5
1
1
1
1
1
1
2,3
2,3
2,3
2,3
24 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
patient see?
Which of the following did the
team?
from a multidisciplinary HF
Did the patient receive input
Main place of care
Date of admission
Postcode
Patient gender
Birth date
Patient name (Forename)
Patient name (Surname)
NHS number
Local patient identifier
Hospital identifier
Field Description
2. Female
9. Not specified
2
9
0. No
0
2. Other consultant with interest in HF
3. HF Specialist nurse
4. Other
9. Unknown
2
3
4
9
1. Consultant cardiologist
9. Unknown
9. Unknown
9
9
3. Other
3
1. Yes
2. General Medicine
2
1
1. Cardiology
1
Date of Admission (dd/mm/yyyy)
Valid Post Code
1. Male
1
Valid date ≥1901 and ≤=1995
Free text
Free text
0. Not known
1
Long Code
10 digit (no spaces) valid NHS Number
Free text
0
Short
Code
The dataset can be downloaded in Excel format from the NICOR website at http://www.ucl.ac.uk/nicor/audits/heartfailure/dataset.
Text (multivalue; separated)
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Date (dd/mm/yyyy)
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Text (single value)
Field Type
M
M
M
M
M
M
M
M
M
M
M
Mandatory
National Heart Failure Audit core dataset, version 317Valid from 26/03/2012
Record
Type
17
8
National Heart Failure Audit core dataset
3.04
4.00
4.01
4.09
4.12
4.14
2,3
2,3
2,3
2,3
2,3
3.01
2,3
2,3
Sequence
Number
Record
Type
Previous diabetes
Previous hypertension
Previous valve disease
Previous AMI
Previous IHD
Peripheral oedema
Breathlessness
Field Description
1. Yes
9. Unknown
1
9
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
3. Severe
3
0
2. Moderate
2
9. Unknown
9
1. Mild
4. Symptoms at rest or minimal activity
4
1
3. Marked limitation of ordinary physical activity
3
0. No
2. Slight limitation of ordinary physical activity
2
0
1. No limitation of physical activity
Long Code
1
Short
Code
Text (single value)
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Field Type
M
M
M
M
M
M
M
Mandatory
National Heart Failure Audit core dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 25
Sequence
Number
4.14a
4.17
8.01
8.02
8.04
8.06
9.01
9.02
9.03
9.04
9.05
9.13
9.16
9.21
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
ECG
QRS Duration
BNP
Electrolytes: Potassium (K)
Electrolytes: Sodium (Na)
Creatinine
Urea
Hb
Blood pressure - systolic
Heart rate
Weight
Height
Previous COPD
Previous Asthma
Field Description
9. Unknown
9
Long Code
1. Sinus rhythm
2. Atrial fibrillation
3. LBBB
4. Previous MI
6. Not done - planned after discharge
7. Not done - not yet planned
8. Other
9. Unknown
1
2
3
4
6
7
8
9
QRS Duration
BNP
Electrolytes-K
Electrolytes-NA
Full blood count creatinine
Full blood count urea
Full blood count Hb
Blood pressure - systolic (mmHg)
Heart rate on admission (bmp)
Weight (Kg)
Height (cm)
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Short
Code
26 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
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Numeric (real)
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Numeric (real)
Numeric (real)
Text (single value)
Text (single value)
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Field Type
M
M
M
Mandatory
National Heart Failure Audit core dataset
11.01
9.23
2,3
2,3
Sequence
Number
Record
Type
Treatment ACE inhibitor
Angiogram)
test e.g MRI,Nuclear Scan or
ECHO (or other gold standard
Field Description
3. Lisinopril
4. Perindopril
5. Ramipril
6. Trandolapril
7. Other ACEI
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
4
5
6
7
8
9
10
11
12
9. Unknown
9
3
8. Other
8
2. Enalpril
7. Test not done - not yet planned
7
2
6. Test not done - planned after discharge
6
1. Captopril
4. Diastolic dysfunction
4
1
3. Valve disease
3
0. No
2. LV hypertrophy
2
0
1. LV systolic dysfunction
0. Normal
Long Code
1
0
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
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Field Type
M
M
Mandatory
National Heart Failure Audit core dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 27
Sequence
Number
11.04
11.06
Record
Type
2,3
2,3
Treatment beta blocker
Treatment ARB
Field Description
4. Other beta blocker
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
8
9
10
11
12
12. Declined by patient
12
4
11. Contraindicated
11
3. Nebivolol
10. Drug therapy stopped
10
3
9. Unknown
9
2. Carvedilol
8. Not applicable
8
2
4. Other ARB
4
1. Bisoprolol
3. Valsartan
3
1
2. Losartan
2
0. No
1. Candesartan
1
0
0. No
0
Short
Code
Long Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
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Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
M
M
Mandatory
National Heart Failure Audit core dataset
28 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
11.11
11.09
2,3
2,3
Sequence
Number
Record
Type
Treatment thiazide diuretic
Treatment loop diuretic
Field Description
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
9
10
11
12
12. Declined by patient
12
8. Not applicable
11. Contraindicated
11
8
10. Drug therapy stopped
10
3. Other thiazide
9. Unknown
9
3
8. Not applicable
8
2. Metolazone
5. Other loop diuretic
5
2
4. Torasemide
4
1. Bendroflumethazide
3. Furosemide
3
1
2. Ethancrynic acid
2
0. No
1. Bumetanide
1
0
0. No
0
Short
Code
Long Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
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Text (single value)
Text (single value)
Text (single value)
Field Type
M
M
Mandatory
National Heart Failure Audit core dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 29
Sequence
Number
11.13
11.20
12.01
14.00
Record
Type
2,3
2,3
2,3
2,3
30 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Diagnosis of heart failure
Treatment device therapy
Treatment digoxin
Treatment ARA
Field Description
9. Unknown
9
12. Declined by patient
12
1. Yes
4. PM
4
1
3. ICD
3
0. No
2. CRT-P
2
0
1. CRT-D
1
12. Declined by patient
12
0. None
11. Contraindicated
11
0
10. Drug therapy stopped
10
12. Declined by patient
12
9. Unknown
11. Contraindicated
11
9
10. Drug therapy stopped
10
8. Not applicable
9. Unknown
9
8
8. Not applicable
8
1. Yes
3. Other ARA
3
1
2. Spironolactone
2
0. No
1. Eplerenone
1
0
0. No
0
Short
Code
Long Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
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Text (single value)
Text (single value)
Text (single value)
Field Type
M
M
M
M
Mandatory
National Heart Failure Audit core dataset
15.06
15.07
15.08
15.10
2,3
2,3
2,3
2,3
15.01
2,3
15.05
15.00
2,3
2,3
Sequence
Number
Record
Type
Date of discharge
GP
Cardiology follow up
COTE/medical follow up
Palliative care
Cardiac rehabilitation
HF liaison service
Field Description
9. Unknown
9
Long Code
Date of discharge (dd/mm/yyyy)
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
8. Not applicable
8
0
1. Yes
12. Declined by patient
12
1
9. Unknown
9
0. No
8. Not applicable
8
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Short
Code
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
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Text (single value)
Text (single value)
Text (single value)
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Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
M
M
M
M
M
M
M
Mandatory
National Heart Failure Audit core dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 31
Sequence
Number
15.11
15.12
15.13
15.14
15.15
16.01
16.02
17.01
17.02
Record
Type
2,3
2,3
2,3
2,3
2,3
4
4
5
32 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
5
Life status
Life status date
Event
Event date
Patient died
planning?
oral therapy after discharge
Was the patient stable on
appointment
Date of heart failure review
HF team made?
the specialist multidisciplinary
Was a review appointment with
Discharge planning
Field Description
1. Yes
1
2. Admission for CHF
3. Other CV admission
4. Other non-CV admission
5. Unscheduled OP visit
6. Other event
2
3
4
5
6
1. Alive
2. Dead
1
2
Life status date (dd/mm/yyyy)
1. Death
1
Event Date (dd/mm/yyyy)
0. No
9. Unknown
9
0
1. Yes
0. No
1
0
Date of review appointment (dd/mm/yyyy)
9. Unknown
0. No
0
9
9. Unknown
9
1. Yes
5. None of the above
5
1
4. All of the above
the primary care team
3. A heart failure management plan has been communicated to
4
3
2. A heart-failure management plan has been discussed with the
2
patient
1. A heart failure pre-discharge management plan is in place
Long Code
1
Short
Code
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
M
M
M
M
M
M
M
M
Mandatory
National Heart Failure Audit core dataset
18
Sequence
Number
1.01
1.02
1.03
1.04
1.05
1.06
1.07
1.08
1.09
1.10
1.11
1,2,3,4,5
1,2,3,4,5
1
1
1
1
1
1
1
1
1
Other Social Issues
Living Alone
Postcode Of Usual Address
Patient Ethnic Group
Patient Gender
Birth Date
Patient Name (Forename)
Patient Name (Surname)
NHS Number
Local Patient Identifier
Hospital identifier
Field Description
Long Code
3. Asian
4. Oriental
8. Other
9. Unknown
3
4
8
9
2. Transport
3. Carer
4. Accommodation
2
3
4
9. Unknown
9
1. Stairs at home
1. Yes
1
1
0. No
0
Valid Post Code
2. Black
9. Not specified
9
2
2. Female
2
1. Caucasian
1. Male
1
1
0. Not known
Valid date >1901 and <=1995
Free text
Free text
10 digit (no spaces) valid NHS Number
Free text
0
Short
Code
The dataset can be downloaded in Excel format from the NICOR website at http://www.ucl.ac.uk/nicor/audits/heartfailure/dataset.
Text (multivalue; separated)
Text (single value)
Free text
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Free text
Free text
Free text
Free text
Text (single value)
Field Type
National Heart Failure Audit full dataset, version 318Valid from 26/03/2012
Record
Type
9
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 33
Sequence
Number
1.12
1.13
2.00
2.01
2.02
Record
Type
1
1
2,3
2
2
Referral Route
Referral Reason
Date of Admission
GP Name
Occupation
Field Description
2. Clerical
3. Manual
4. Unemployed
5. Retired
6. Other
2
3
4
5
6
3. Hospital out-patient from secondary care (could
include cardiology, COTE and other)
4. Urgent admission for or with heart failure
5. In-patient diagnosis of HF after urgent admission for
other CV condition
6. In-patient diagnosis of HF after urgent admission for
non-CV condition
7. In-patient diagnosis of HF after routine CV admission
8. In-patient diagnosis of HF after routine non-CV
admission
9. Other referral route
3
4
5
6
7
8
9
5. Other
5
2. Hospital out-patient from primary care
4. Investigation of need for (loop) diuretics
4
2
3. Suspected LV dysfunction (eg:- post-MI, subsequent
to an arrhythmia)
3
1. Diagnosed and managed in primary care alone
2. Suspected heart failure (eg:- admission with acute
breathlessness or referral with oedema or increasing
breathlessness on exertion)
2
1
1. Known case of heart failure prior to referral
1
Date of Admission (dd/mm/yyyy)
GP Name
1. Professional/Managerial
Long Code
1
Short
Code
Text (single value)
Text (multivalue; separated)
Date (dd/mm/yyyy)
Free text
Text (single value)
Field Type
National Heart Failure Audit full dataset
34 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2.04ai
2.05
2.06
2.07
3.01
2,3
3
3
3
2,3
2.04
2,3
2.04a
2.03
2,3
2,3
Sequence
Number
Record
Type
Breathlessness
Outpatient
Inpatient
Unscheduled Event
Which of the following did the patient see?
Received input from a multidisciplinary HF Team
Main place of care
Recent inpatient
Field Description
1. No limitation of physical activity
2. Slight limitation of ordinary physical activity
3. Marked limitation of ordinary physical activity
4. Symptoms at rest or minimal activity
9. Unknown
2
3
4
9
1. Yes
1
1
0. No
1. Yes
1
0
0. No
0
9. Unknown
9
9. Unknown
9
1. Yes
4. Other
4
1
3. HF Specialist nurse
3
0. No
2. Other consultant with interest in heart failure
2
0
1. Consultant cardiologist
9. Unknown
9
Long Code
1
1. Yes
1
9. Unknown
9
0. No
3. Other
3
0
2. General Medicine
2
3. Other
3
1. Cardiology
2. General Medicine
2
1
1. Cardiology
1
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (multivalue; separated)
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 35
Sequence
Number
3.02
3.03
3.04
3.05
4.00
4.01
4.02
4.03
4.04
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
36 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
2,3
CABG Date
Previous CABG
Previous MI Date
Previous AMI
Previous IHD
Other Symptom
Peripheral Oedema
Fatigue
CCS Angina Status
Field Description
2. Moderate
3. Severe
9. Unknown
2
3
9
9. Unknown
9
1. Yes
9. Unknown
1
9
CABG Date (dd/mm/yyyy)
0. No
0
Previous MI Date (dd/mm/yyyy)
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Other Symptom
1. Mild
1
9. Unknown
9
0. No
3. Severe
3
0
2. Moderate
2
4. Inability to perform any physical activity without
discomfort
4
1. Mild
3. Marked limitation of ordinary physical activity
3
1
2. Slight limitation of ordinary activity
2
0. No
1. Angina which does not limit ordinary physical activity.
1
0
0. No angina
Long Code
0
Short
Code
Date (dd/mm/yyyy)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Free text
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
Sequence
Number
4.05
4.06
4.07
4.08
4.09
4.10
4.11
4.12
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
Previous Hypertension
Previous Arrhythmia
Previous Congenital heart disease
Previous Valve Disease
Previous Device Mode
Previous Device Therapy
PCI Date
Previous PCI
Field Description
1. Yes
9. Unknown
1
9
Long Code
0. No
1. Yes
9. Unknown
1
9
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
9. Unknown
7. VVIR
7
9
6. VVI
6
1. Yes
5. OOO
5
1
4. DDDR
4
0. No
3. DDD
3
0
2. AAIR
4. PM
4
2
3. ICD
3
1. AAI
2. CRT-P
2
1
1. CRT-D
1
PCI Date (dd/mm/yyyy)
0. No
0
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 37
Sequence
Number
4.13
4.14
4.14a
4.15
4.16
4.17
4.18
4.19
4.20
5.01
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
38 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
2,3
Social History Alcohol
Past Medical History Other
Previous Gout
Previous Arthritis
Previous COPD
Previous PVD
Previous CVA
Previous Asthma
Previous Diabetes
Previous Chronic Renal Impairment
Field Description
9. Unknown
9
Long Code
Social History Alcohol (units/week)
Past Medical History Other
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Short
Code
Numeric (integer)
Free text
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
6.03
6.04
7.01
7.02
2,3
2,3
2,3
2,3
6.01
2,3
6.02
5.02
2,3
2,3
Sequence
Number
Record
Type
ACEI Dose
ACEI
Family history Cardiomyopathy
Family history Muscular Dystrophy
Family history IHD/Other cardiac
Family history HF
Social History Smoking
Field Description
2. Enalapril
3. Lisinopril
4. Perindopril
5. Ramipril
6. Trandolapril
7. Other ACEI
9. Unknown
2
3
4
5
6
7
9
ACEI Dose
1. Captopril
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
3. Never
3
0. No
2. Ex
2
0
1. Yes
1
Short
Code
Long Code
Numeric (real)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 39
Sequence
Number
7.03
7.04
7.05
7.06
7.07
7.08
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
Beta blocker Reason
Beta Dose
Beta Blocker
ARB Dose
ARB
ACE I Reason
Field Description
3. Valsartan
4. Other ARB
9. Unknown
3
4
9
1. Bisoprolol
2. Cardvedilol
3. Nebivolol
4. Other beta blocker
9. Unknown
1
2
3
4
9
1. Bradycardia or Heart Block
2. Low Arterial Pressure
3. Worstening Heart Failure
4. Intolerable Fatigue
5. Respiratory Disease
6. Other Intolerance
7. Not indicated
1
2
3
4
5
6
7
Beta blocker Dose
0. No
0
ARB Dose
2. Losartan
2
5. Not indicated
5
1. Candesartan
4. Other intolerance to ACE
4
1
3. Renal dysfunction
3
0. No
2. Low Arterial Pressure
2
0
1. Cough
Long Code
1
Short
Code
Text (single value)
Numeric (real)
Text (single value)
Numeric (real)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
40 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
7.10
7.11
7.12
7.13
7.14
7.15
7.16
7.17
2,3
2,3
2,3
2,3
2,3
2,3
2,3
7.09
2,3
2,3
Sequence
Number
Record
Type
Aspirin Dose
Aspirin
SARA Dose
SARA Reason
SARA
Thiazide Dose
Diuretic: Thiazide
Loop Dose
Diuretic: loop
Field Description
1. Bumetanide
2. Ethancrynic acid
3. Frusemide
4. Torasemide
9. Unknown
1
2
3
4
9
1. Bendroflumethazide
2. Metolazone
3. Other Thiazide
9. Unknown
1
2
3
9
3. Gynaecomastia
4. Other
5. Not indicated
3
4
5
1. Yes
9. Unknown
1
9
Aspirin Dose
0. No
0
SARA Dose
2. Renal Dysfunction
9. Unknown
9
2
2. Spironolactone
2
1. Hyperkalemia
1. Eplerenone
1
1
0. No
0
Thiazide Dose
0. No
0
Loop Dose
0. No
0
Short
Code
Long Code
Numeric (integer)
Text (single value)
Numeric (real)
Text (single value)
Text (single value)
Numeric (real)
Text (single value)
Numeric (real)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 41
Sequence
Number
7.18
7.18
7.18
7.18
7.19
7.20
7.21
7.22
7.23
7.24
7.25
7.26
7.26
7.26
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
42 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
Warfarin HF
Therapy for Lipids Dose
Therapy for Lipids
CCB Dose
CCB
Digoxin Dose
Digoxin
Other Anti-platelet Dose
Other oral anti-platelet
Field Description
1. Clopidogrel
2. Other oral antiplatelet
9. Unknown
1
2
9
1. Yes
9. Unknown
1
9
1. Amlodipine
2. Felodipine
3. Diltiazem
4. Verapamil
5. Other CCB
9. Unknown
1
2
3
4
5
9
1. Atorvastatin
2. Pravastatin
3. Rosuvastatin
4. Simvastatin
9. Unknown
1
2
3
4
9
0. No
1. Yes
9. Unknown
0
1
9
Therapy for Lipids Dose
0. No
0
CCB Dose
0. No
0
Digoxin Dose
0. No
0
Other Anti-platelet Dose
0. No
Long Code
0
Short
Code
Text (single value)
Numeric (integer)
Text (single value)
Numeric (integer)
Text (single value)
Numeric (real)
Text (single value)
Numeric (integer)
Text (single value)
Field Type
National Heart Failure Audit full dataset
7.31
7.32
7.33
7.34
7.35
7.36
2,3
2,3
2,3
2,3
2,3
7.29
2,3
2,3
7.28
2,3
7.30
7.27
2,3
2,3
Sequence
Number
Record
Type
Bronchodilators
Nitrate Dose
Nitrates HF
NSAID
Allopurinol Dose
Allopurinol
Amiodarone Dose
Amiodarone
Warfarin Dose
INR
Field Description
1. Yes
9. Unknown
1
9
1. Yes
9. Unknown
1
9
2. ISMN
9. Unknown
2
9
0. No
1. Yes
9. Unknown
0
1
9
Nitrate Dose
1. ISDN
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Allopurinol Dose
0. No
0
Amiodarone Dose
0. No
Warfarin Dose
INR
0
Short
Code
Long Code
Text (single value)
Numeric (integer)
Text (single value)
Text (single value)
Numeric (integer)
Text (single value)
Numeric (integer)
Text (single value)
Numeric (real)
Numeric (real)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 43
Sequence
Number
7.37
7.38
7.39
8.01
8.02
8.03
8.04
8.05
8.06
8.07
8.08
8.09
8.10
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
44 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
Added Heart Sounds
Murmurs
JVP
Blood pressure - diastolic
Blood pressure - systolic
Heart Rhythm
Heart rate
BMI
Weight
Height
Other treatment
Current Trial Medication
Current Diabetes Therapy
Field Description
1. Diabetes (dietary control)
2. Metformine
3. Sulphonylurea
4. Glitazone
5. Other Oral
6. Diabetic (insulin)
7. Newly diagnosed diabetic
9. Unknown
1
2
3
4
5
6
7
9
2. Irregular
2
1. S3
2. S4
1
2
2. Diastolic
2
3. Normal
3
1. Systolic
2. Raised
2
1
1. Invisible
1
Blood pressure - diastolic
Blood pressure - systolic (mmHg)
1. Regular
1
Heart rate on admission (bpm)
BMI
Weight (Kg)
Height (cm)
Other treatment
Current Trial Medication
0. Not diabetic
Long Code
0
Short
Code
Text (multivalue; separated)
Text (multivalue; separated)
Text (single value)
Numeric (integer)
Numeric (integer)
Text (single value)
Numeric (integer)
Numeric (real)
Numeric (real)
Numeric (real)
Free text
Free text
Text (single value)
Field Type
National Heart Failure Audit full dataset
Sequence
Number
8.11
8.13
9.01
9.02
9.03
9.04
9.05
9.06
9.07
9.08
9.09
9.10
9.11
9.12
9.13
9.14
9.15
9.16
9.17
9.18
9.19
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
RBBB
LBBB
QT Duration (Uncorrected)
QRS Duration
Total Cholesterol
NT-BNP
BNP
T4
TSH
Glucose
GammaGT
ALT
AST
Bilirubin
Electrolytes-K
Electrolytes-NA
Creatinine
Urea
Hb
Physical Exam Other
Lung Fields
Field Description
2. Rales
2
Long Code
1. Yes
9. Unknown
1
9
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
QT Duration (uncorrected)
QRS Duration
Total Cholesterol
NT-BNP
BNP
TFTs T4
TFTs TSH
Glucose
LFTs GammaGT
LFTs ALT
LFTs AST
LFTs Bilirubin
Electrolytes-K
Electrolytes-NA
Full blood count creatinine
Full blood count urea
Full blood count Hb
Physical Exam Other
1. Clear
1
Short
Code
Text (single value)
Text (single value)
Numeric (integer)
Numeric (integer)
Numeric (real)
Numeric (integer)
Numeric (integer)
Numeric (real)
Numeric (real)
Numeric (real)
Numeric (integer)
Numeric (integer)
Numeric (integer)
Numeric (integer)
Numeric (real)
Numeric (integer)
Numeric (integer)
Numeric (real)
Numeric (real)
Free text
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 45
Sequence
Number
9.20
9.21
9.22
9.23
9.24
9.25
Record
Type
2,3
2,3
2,3
2,3
2,3
46 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
Echo Diastolic dysfunction
Echo Systolic dysfunction
ECHO (or other gold standard test e.g MRI,Nuclear
Scan or Angiogram)
ECG Rate
ECG
ECG Previous MI
Field Description
3. LBBB
4. Previous MI
6. Not done - planned after discharge
7. Not done - not yet planned
8. Other
9. Unknown
3
4
6
7
8
9
7. Test not done - not yet planned
8. Other
9. Unknown
7
8
9
0. No
1. Yes
9. Unknown
0
1
9
9. Unknown
6. Test not done - planned after discharge
6
9
4. Diastolic dysfunction
4
1. Yes
3. Valve disease
3
1
2. LV hypertrophy
2
0. No
1. LV systolic dysfunction
1
0
0. Normal
0
ECG Rate
2. Atrial fibrillation
2
9. Unknown
9
1. Sinus rhythm
1. Yes
1
Long Code
1
0. No
0
Short
Code
Text (single value)
Text (single value)
Text (multivalue; separated)
Numeric (integer)
Text (multivalue; separated)
Text (single value)
Field Type
National Heart Failure Audit full dataset
9.27
9.28
9.29
9.30
9.31
9.32
9.33
9.34
2,3
2,3
2,3
2,3
2,3
2,3
2,3
9.26
2,3
2,3
Sequence
Number
Record
Type
Chest X ULVD
Chest X Cardiothoracic ratio
MUGA Inducible Ischaemia
MUGA LVEF Abnormal
MRI Diastolic Dysfunction
MRI Systolic Dysfunction
Echo Other
Echo Mitral Valve Disease
Echo Aortic Valve disease
Field Description
3. Stenosis and Regurgitation
9. Unknown
3
9
9. Unknown
9
0. No
1. Yes
9. Unknown
0
1
9
Cardiothoracic ratio
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Echo Other
2. Regurgitation
2
9. Unknown
9
1. Stenosis
3. Stenosis and Regurgitation
3
1
2. Regurgitation
2
0. No
1. Stenosis
1
0
0. No
Long Code
0
Short
Code
Text (single value)
Numeric (real)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Free text
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 47
Sequence
Number
9.35
9.36
9.37
9.38
9.39
9.40
9.41
9.42
9.43
9.44
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
48 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Angio LCX
Angio LAD dist
Angio LAD prox
Angio L Main
Angio LV dysfunction
ETT ST Depression
ETT Chest Pain
Total Excercise seconds
Total Excercise minutes
Chest X Pulmonary Oedema
Field Description
1. Yes
9. Unknown
1
9
Long Code
0. No
1. Yes
9. Unknown
1
9
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Total Exercise seconds
Total Exercise minutes
0. No
0
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Numeric (integer)
Numeric (integer)
Text (single value)
Field Type
National Heart Failure Audit full dataset
Sequence
Number
9.45
9.46
11.01
11.02
11.03
Record
Type
2,3
2,3
2,3
2,3
2,3
Treatment ACE I reason
Treatment ACEI Dose
Treatment ACE I
Other test
Angio RCA
Field Description
1. Yes
9. Unknown
1
9
Long Code
1. Captopril
2. Enalpril
3. Lisinopril
4. Perindopril
5. Ramipril
6. Trandolapril
7. Other ACEI
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
1
2
3
4
5
6
7
8
9
10
11
12
1. Cough
2. Low Arterial Pressure
3. Renal dysfunction
4. Other intolerance to ACE
5. Not Indicated
1
2
3
4
5
Treatment ACEI Dose
0. No
0
Past Medical History Other
0. No
0
Short
Code
Text (single value)
Numeric (real)
Text (single value)
Free text
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 49
Sequence
Number
11.04
11.05
11.06
11.07
Record
Type
2,3
2,3
2,3
2,3
50 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Treatment Beta blocker Dose
Treatment Beta blocker
Treatment ARB Dose
Treatment ARB
Field Description
1. Candesartan
2. Losartan
3. Valsartan
4. Other ARB
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
1
2
3
4
8
9
10
11
12
1. Bisoprolol
2. Carvedilol
3. Nebivolol
4. Other beta blocker
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
1
2
3
4
8
9
10
11
12
Treatment beta blocker Dose
0. No
0
Treatment ARB Dose
0. No
Long Code
0
Short
Code
Numeric (real)
Text (single value)
Numeric (real)
Text (single value)
Field Type
National Heart Failure Audit full dataset
11.09
11.10
2,3
11.08
2,3
2,3
Sequence
Number
Record
Type
Treatment Loop Dose
Treatment Loop Diuretic
Treatment Beta reason
Field Description
4. Torasemide
5. Other loop diuretic
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
4
5
8
9
10
11
12
Treatment Loop Dose
3. Furosemide
3
7. Not Indicated
7
2. Ethancrynic acid
6. Other Intolerance
6
2
5. Respiratory Disease
5
1. Bumetanide
4. Intolerable Fatigue
4
1
3. Worsening Heart Failure
3
0. No
2. Low Arterial Pressure
2
0
1. Bradycardia or Heart Block
Long Code
1
Short
Code
Numeric (real)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 51
Sequence
Number
11.11
11.12
11.13
11.14
11.15
Record
Type
2,3
2,3
2,3
2,3
2,3
52 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Treatment ARA Dose
Treatment ARA Reason
Treatment ARA
Treatment Thiazide Dose
Treatment Thiazide Diuretic
Field Description
1. Bendroflumethazide
2. Metolazone
3. Other thiazide
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
1
2
3
8
9
10
11
12
ARA Dose
5. Not Indicated
5
12. Declined by patient
12
4. Other
11. Contraindicated
11
4
10. Drug therapy stopped
10
3. Gynaecomastia
9. Unknown
9
3
8. Not applicable
8
2. Renal Dysfunction
3. Other ARA
3
2
2. Spironolactone
2
1. Hyperkalemia
1. Eplerenone
1
1
0. No
0
Thiazide Dose
0. No
Long Code
0
Short
Code
Numeric (real)
Text (single value)
Text (single value)
Numeric (real)
Text (single value)
Field Type
National Heart Failure Audit full dataset
Sequence
Number
11.16
11.17
11.18
11.19
11.20
11.21
11.22
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
Treatment CCB
Treatment Digoxin Dose
Treatment Digoxin
Treatment Other Anti-platelet Dose
Treatment Other oral anti-platelet
Treatment Aspirin Dose
Treatment Aspirin
Field Description
1. Yes
9. Unknown
10. Drug therapy stopped
1
9
10
1. Clopidogrel
2. Other oral antiplatelet
9. Unknown
10. Drug therapy stopped
1
2
9
10
1. Yes
8. Not applicable
9. Unknown
10. Drug therapy stopped
11. Contraindicated
12. Declined by patient
1
8
9
10
11
12
0. No
1. Amlodipine
2. Felodipine
3. Diltiazem
4. Verapamil
5. Other CCB
9. Unknown
10. Drug therapy stopped
0
1
2
3
4
5
9
10
Treatment Digoxin Dose
0. No
0
Treatment Other Anti-platelet Dose
0. No
0
Treatment Aspirin Dose
0. No
Long Code
0
Short
Code
Text (single value)
Numeric (real)
Text (single value)
Numeric (integer)
Text (single value)
Numeric (integer)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 53
Sequence
Number
11.23
11.24
11.25
11.26
11.27
11.28
11.29
11.30
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
54 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Treatment Amiodarone Dose
Treatment Amiodarone
Treatment Warfarin Dose
Treatment INR
Treatment Warfarin
Treatment Therapy for Lipids Dose
Treatment Therapy for Lipids
Treatment CCB Dose
Field Description
1. Atorvastatin
2. Pravastatin
3. Rosuvastatin
4. Simvastatin
5. Other Lipid
6. Fibrate
7. Ezetimibe
8. Other Lipid Therapy
9. Unknown
10. Drug therapy stopped
1
2
3
4
5
6
7
8
9
10
1. Yes
9. Unknown
10. Drug therapy stopped
1
9
10
1. Yes
9. Unknown
10. Drug therapy stopped
1
9
10
Treatment Amiodarone Dose
0. No
0
Treatment Warfarin Dose
Treatment INR
0. No
0
Treatment Therapy for Lipids Dose
0. No
Treatment CCB Dose
Long Code
0
Short
Code
Numeric (integer)
Text (single value)
Numeric (real)
Numeric (real)
Text (single value)
Numeric (integer)
Text (single value)
Numeric (integer)
Field Type
National Heart Failure Audit full dataset
Sequence
Number
11.31
11.32
11.33
11.34
11.35
11.36
11.37
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
Treatment Diabetes therapy
Treatment Bronchodilators
Treatment Nitrate Dose
Treatment Nitrates
Treatment NSAID
Treatment Allopurinol Dose
Treatment Allopurinol
Field Description
1. Yes
9. Unknown
10. Drug therapy stopped
1
9
10
2. ISMN
9. Unknown
10. Drug therapy stopped
2
9
10
1. Diabetes (dietary control)
2. Metformine
3. Sulphonylurea
4. Glitazone
5. Other Oral
6. Diabetic (insulin)
7. Newly diagnosed diabetic
9. Unknown
2
3
4
5
6
7
9
10. Drug therapy stopped
10
1
9. Unknown
9
0. Not diabetic
1. Yes
1
0
0. No
0
Treatment Nitrate Dose
1. ISDN
10. Drug therapy stopped
10
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Treatment Allopurinol Dose
0. No
Long Code
0
Short
Code
Text (single value)
Text (single value)
Numeric (integer)
Text (single value)
Text (single value)
Numeric (integer)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 55
Sequence
Number
11.38
11.39
12.01
12.02
12.03
12.04
12.05
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
56 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Treatment VAD
Treatment PCI
Treatment cardiac surgery
Treatment Device Mode
Treatment Device therapy
Treatment clinical trial medication
Other Treatment
Field Description
0. No
1. Yes
9. Unknown
1
9
9. Unknown
9
0
1. Yes
1
8. Other
8
0. No
4. Cardiac transplant
4
0
3. Other valve surgery
3
7. VVIR
7
2. MVR
6. VVI
6
2
5. OOO
5
1. CABG
4. DDDR
4
1
3. DDD
12. Declined by patient
12
3
4. PM
4
2. AAIR
3. ICD
3
2
2. CRT-P
2
1. AAI
1. CRT-D
1
1
0. None
Free text
Free text
Long Code
0
Short
Code
Text (single value)
Text (single value)
Text (multivalue; separated)
Text (single value)
Text (single value)
Free text
Free text
Field Type
National Heart Failure Audit full dataset
Sequence
Number
12.06
13.01
13.02
13.03
14.00
14.01
14.02
14.03
14.04
14.05
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
Dx Alcohol
Dx Arrhythmia
Dx Hypertension
Dx Valve disease
Dx Ischaemic heart disease
Dx Heart Failure
QOL Other
QOL VAS
QOL Minnesota
Treatment cardiac rhythm management
Field Description
2. Intervention (unspecified)
3. Intervention (pulmonary vein isolation)
4. Other
2
3
4
1. Yes
9. Unknown
1
9
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
QOL Other
QOL VAS
QOL Minnesota
1. EP study
Long Code
1
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Numeric (integer)
Numeric (integer)
Numeric (real)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 57
Sequence
Number
14.06
14.07
14.08
14.09
14.10
14.11
14.12
14.13
15.00
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
2,3
58 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
2,3
HF Liaison Service
Other diagnosis
Dx Pulmonary Embolism
Dx Anaemia
Dx Deconditioning
Dx Obesity
Dx COPD
Dx Asymptomatic LVSD
Dx Cardiomyopathy
Field Description
1. Yes
9. Unknown
1
9
0. No
1. Yes
9. Unknown
0
1
9
Other diagnosis
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
9. Unknown
9
9. Unknown
9
1. Yes
8. Other
8
1
2. HCM
2
0. No
1. DCM
1
0
0. No
0
Short
Code
Long Code
Text (single value)
Free text
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
15.02
15.03
15.04
15.05
15.06
15.07
15.08
2,3
2,3
2,3
2,3
2,3
2,3
15.01
2,3
2,3
Sequence
Number
Record
Type
GP
Cardiology FU
COTE/Medical
Palliative Care
Transplant
Cardiothoracic Surgery
Social Work
Cardiac Rehabilitation
Field Description
1. Yes
9. Unknown
1
9
9. Unknown
9
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
9. Unknown
9
1
8. Not applicable
8
0. No
1. Yes
1
0
0. No
9. Unknown
9
0
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
9. Unknown
9
12. Declined by patient
12
1. Yes
9. Unknown
9
1
8. Not applicable
8
0. No
1. Yes
1
0
0. No
Long Code
0
Short
Code
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Text (single value)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 59
Sequence
Number
15.09
15.10
15.11
15.12
15.13
15.14
15.15
16.01
16.02
Record
Type
2,3
2,3
2,3
2,3
2,3
2,3
2,3
4
4
Event
Event date
Patient died
Was the patient stable on oral therapy after discharge
planning?
Date of heart failure review appointment
A review appointment with the specialist MD heart
failure team made
Discharge Planning
Date of discharge
Other
Field Description
1. Death
2. Admission for CHF
3. Other CV admission
4. Other non-CV admission
5. Unscheduled OP visit
6. Other event
1
2
3
4
5
6
Event Date (dd/mm/yyyy)
1. Yes
1
9. Unknown
9
0. No
1. Yes
1
0
0. No
0
Date of review appointment (dd/mm/yyyy)
9. Unknown
9. Unknown
9
9
5. None of the above
5
1. Yes
4. All of the above
4
1
3. A heart failure management plan has been
communicated to the primary care team
3
0. No
2. A heart-failure management plan has been discussed
with the patient
2
0
1. A heart failure pre-discharge management plan is in
place
Date of discharge (dd/mm/yyyy)
FU Other
Long Code
1
Short
Code
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Text (single value)
Field Type
National Heart Failure Audit full dataset
60 • National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012
Sequence
Number
16.03
16.04
17.01
17.02
17.03
17.04
Record
Type
4
4
5
5
5
5
Death (Info Source)
Death (reason)
Life status
Life status date
Hospitalisation (duration)
Hospitalisation (treatment)
Field Description
2. Need for CPAP
2
Long Code
2. Death Certificate
3. ONS
4. Hospital records
5. G.P records
6. Verbal contract
9. Other
3
4
5
6
9
4. Non CV
4
2
3. Other CV
3
1. Autopsy
2. Worsening HF
2
1
1. Sudden
2. Dead
2
1
1. Alive
1
Life status date (dd/mm/yyyy)
Hospitalisation (duration)
1. Need for IV diuretics
1
Short
Code
Text (single value)
Text (single value)
Text (single value)
Date (dd/mm/yyyy)
Numeric (integer)
Text (multivalue; separated)
Field Type
National Heart Failure Audit full dataset
National Heart Failure Audit – Application Notes: Dataset Version 3 Valid From 26th March 2012 • 61
NATIONAL HEART FAILURE AUDIT
Application Notes
Dataset version 3. Valid from 26th March 2012