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Presentation
Improved Survival after Heart Failure: A Community-based Perspective
Senior Scholars Program
  • Kristy T. Webster, University of Massachusetts Medical School
  • Samuel W. Joffe, University of Massachusetts Medical School
  • David D. McManus, University of Massachusetts Medical School
  • MIchael S. Kiernan, University of Massachusetts Medical School
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Chad E. Darling, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine; Department of Quantitative Health Sciences; Department of Emergency Medicine; Meyers Primary Care Institute
Faculty Advisor
Robert J. Goldberg
Date
5-1-2013
Document Type
Poster
Medical Subject Headings
Heart Failure; Survival Rate; Outcome Assessment (Health Care)
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.
Comments

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

Citation Information
Kristy T. Webster, Samuel W. Joffe, David D. McManus, MIchael S. Kiernan, et al.. "Improved Survival after Heart Failure: A Community-based Perspective" (2013)
Available at: http://works.bepress.com/robert_goldberg/374/