Improved Survival after Heart Failure: A Community-based Perspective
AuthorsWebster, 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 AdvisorRobert J. Goldberg
UMass Chan AffiliationsMeyers Primary Care Institute
Department of Emergency Medicine
Department of Quantitative Health Sciences
Department of Medicine, Division of Cardiovascular Medicine
Outcome Assessment (Health Care)
Health Services Research
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AbstractBackground: 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.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/49211
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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