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    Improved Survival after Heart Failure: A Community-based Perspective

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    Authors
    Webster, Kristy T.
    Joffe, Samuel W.
    McManus, David D.
    Kiernan, MIchael S.
    Lessard, Darleen M.
    Yarzebski, Jorge L.
    Darling, Chad E.
    Gore, Joel M.
    Goldberg, Robert J.
    Faculty Advisor
    Robert J. Goldberg
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Emergency Medicine
    Department of Quantitative Health Sciences
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Poster
    Publication Date
    2013-05-01
    Keywords
    Heart Failure
    Survival Rate
    Outcome Assessment (Health Care)
    Cardiovascular Diseases
    Clinical Epidemiology
    Health Services Research
    
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    Abstract
    Background: Heart failure is a highly prevalent, morbid, and costly disease with a poor long-term prognosis. Evidence-based therapies utilized over the past 2 decades hold the promise of improved outcomes, yet few contemporary studies have examined survival trends in patients with acute heart failure. Objectives: The primary objective of this population-based study was to describe trends in short and long-term survival in patients hospitalized with acute decompensated heart failure (ADHF). A secondary objective was to examine patient characteristics associated with decreased long-term survival. Methods and Results: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during 1995, 2000, 2002, and 2004. Patients hospitalized with ADHF were more likely to be elderly and to have been diagnosed with multiple comorbidities in 2004 compared with 1995. Over this period, survival was significantly improved in-hospital, and at 1, 2, and 5 years post-discharge. Five-year survival rates increased from 20% in 1995 to 28% in 2004. Although survival improved substantially over time, older patients and patients with chronic kidney disease, chronic obstructive pulmonary disease, anemia, low body mass index, and low blood pressures had consistently lower post-discharge survival rates than patients without these comorbidities. Conclusion: Between 1995 and 2004, patients hospitalized with ADHF have become older and increasingly comorbid. Although there has been a significant improvement in survival among these patients, their long-term prognosis remains poor, as fewer than 1 in 3 patients hospitalized with ADHF in 2004 survived more than 5 years.
    DOI
    10.13028/1ny4-9513
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49211
    Notes

    Medical student Kristy Webster participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

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