Magnitude of and Prognostic Factors Associated With 1-Year Mortality After Hospital Discharge for Acute Decompensated Heart Failure Based on Ejection Fraction Findings
AuthorsColes, Andrew H.
Yarzebski, Jorge L.
Lessard, Darleen M.
Gore, Joel M.
Darling, Chad E.
Goldberg, Robert J.
UMass Chan AffiliationsDepartment of Emergency Medicine
Department of Medicine, Division of Cardiovascular Medicine
Department of Quantitative Health Sciences
Program in Gene Function and Expression
Document TypeJournal Article
Translational Medical Research
MetadataShow full item record
AbstractBACKGROUND: Limited data exist about the magnitude of and the factors associated with prognosis within 1 year for patients discharged from the hospital after acute decompensated heart failure. Data are particularly limited from the more generalizable perspective of a population-based investigation and should be further stratified according to currently recommended ejection fraction (EF) findings. METHODS AND RESULTS: The hospital medical records of residents of the Worcester, Massachusetts, metropolitan area who were discharged after acute decompensated heart failure from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, 2004, and 2006 were reviewed. The average age of the 4025 study patients was 75 years, 93% were white, and 44% were men. Of these, 35% (n=1414) had reduced EF ( < /=40%), 13% (n=521) had borderline preserved EF (41-49%), and 52% (n=2090) had preserved EF ( > /=50%); at 1 year after discharge, death rates were 34%, 30%, and 29%, respectively (P=0.03). Older age, a history of chronic obstructive pulmonary disease, systolic blood pressure findings < 150 mm Hg on admission, and hyponatremia were important predictors of 1-year mortality for all study patients, whereas several comorbidities and physiological factors were differentially associated with 1-year death rates in patients with reduced, borderline preserved, and preserved EF. CONCLUSIONS: This population-based study highlights the need for further contemporary research into the characteristics, treatment practices, natural history, and long-term outcomes of patients with acute decompensated heart failure and varying EF findings and reinforces ongoing discussions about whether different treatment guidelines may be needed for these patients to design more personalized treatment plans.
SourceJ Am Heart Assoc. 2015 Dec 23;4(12). pii: e002303. doi: 10.1161/JAHA.115.002303. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/50492
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Rights© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Except where otherwise noted, this item's license is described as © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the <a href="http://creativecommons.org/licenses/by-nc/4.0/">Creative Commons Attribution‐NonCommercial</a> License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.