 |
 |

Outcomes of Acute Exacerbation of Severe Congestive Heart Failure
Quality of Life, Resource Use, and Survival
Priit Jaagosild, MD;
Neal V. Dawson, MD;
Charles Thomas, BA;
Neil S. Wenger, MD;
Joel Tsevat, MD, MPH;
William A. Knaus, MD;
Robert M. Califf, MD;
Lee Goldman, MD;
Humberto Vidaillet, MD;
Alfred F. Connors, Jr, MD;
for the SUPPORT Investigators
Arch Intern Med. 1998;158:1081-1089.
Background Congestive heart failure (CHF) is a common disease with high health care costs and high mortality rates. Knowledge of the health-related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this population.
Methods A prospective cohort study was conducted involving 1390 adult patients hospitalized with an acute exacerbation of severe CHF (New York Heart Association class III-IV). Demographic data and health-related quality of life were determined by interview; physiologic status and cost and intensity of care were determined from hospital charts.
Results The median (25th, 75th percentiles) age of patients was 68.0 (58.2, 76.9) years; 61.7% were male. Survival was 93.4% at discharge from the index hospitalization, 72.9% at 180 days, and 61.5% at 1 year. Of patients interviewed at 180 days, the median health rating on a scale of 0 to 100 (0 indicates death; 100, excellent health) was 60 (interquartile range, 50-80), and 59.7% were independent in their activities of daily living. Overall quality of life was reported to be good, very good, or excellent in 58.2% at 180 days. Patients with worse functional capacity were more likely to die. Health perceptions among the patients with available interview data improved at 60 and 180 days after acute exacerbation of severe CHF.
Conclusions Patients hospitalized for acute exacerbation of severe CHF have a generally poor 6-month survival, but survivors retain relatively good functional status and have good health perceptions. Furthermore, health perceptions improve after the acute exacerbation.
From the Departments of Medicine at the following institutions: MetroHealth Medical Center, Case Western Reserve University, Cleveland (Drs Jaagosild and Dawson, and Mr Thomas) and the University of Cincinnati Medical Center, Cincinnati (Dr Tsevat), Ohio; University of California Medical Center, Los Angeles (Dr Wenger); University of Virginia School of Medicine, Charlottesville (Drs Knaus and Connors); Duke University Medical Center, Durham, NC (Dr Califf); University of California, San Franciscov (Dr Goldman); and Marshfield Medical Research Foundation, Marshfield Clinic, Marshfield, Wis (Dr Vidaillet).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
 |
End-of-Life Care in the Critical Care Unit for Patients With Heart Failure
Wingate and Wiegand
Crit Care Nurse 2008;28:84-94.
FULL TEXT
Routine Screening for Depression and Quality of Life in Outpatients With Congestive Heart Failure
Holzapfel et al.
Psychosomatics 2007;48:112-116.
ABSTRACT
| FULL TEXT
Palliation in heart failure: When less and more are more
Hauptman
AM J HOSP PALLIAT CARE 2006;23:150-152.
Natriuretic peptides and E-selectin as predictors of acute deterioration in patients with inotrope-dependent heart failure
Potapov et al.
Eur. J. Cardiothorac. Surg. 2005;27:899-905.
ABSTRACT
| FULL TEXT
Integrating Palliative Care Into Heart Failure Care
Hauptman and Havranek
Arch Intern Med 2005;165:374-378.
ABSTRACT
| FULL TEXT
Admission to intensive care unit at the end-of-life: is it an informed decision?
Rady and Johnson
Palliat Med 2004;18:705-711.
ABSTRACT
End-of-life preferences in elderly patients admitted for heart failure
Formiga et al.
QJM 2004;97:803-808.
ABSTRACT
| FULL TEXT
Outcomes up to 5 Years After Severe, Acute Respiratory Failure
Garland et al.
Chest 2004;126:1897-1904.
ABSTRACT
| FULL TEXT
One-year follow-up of heart failure patients after their first admission
Formiga et al.
QJM 2004;97:81-86.
ABSTRACT
| FULL TEXT
Female sex is associated with a better long-term survival in patients hospitalized with congestive heart failure
Gustafsson et al.
Eur Heart J 2004;25:129-135.
ABSTRACT
| FULL TEXT
Dying from heart failure in hospital
Pujol et al.
QJM 2003;96:777-778.
FULL TEXT
Outcomes in heart failure patients with preserved ejection fraction: Mortality, readmission, and functional decline
Smith et al.
J Am Coll Cardiol 2003;41:1510-1518.
ABSTRACT
| FULL TEXT
Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function
Gustafsson et al.
Eur Heart J 2003;24:863-870.
ABSTRACT
| FULL TEXT
One-year mortality among unselected outpatients with heart failure
Muntwyler et al.
Eur Heart J 2002;23:1861-1866.
ABSTRACT
| FULL TEXT
Electrocardiographic Findings Predict Short-term Cardiac Morbidity After Transient Ischemic Attack
Elkins et al.
Arch Neurol 2002;59:1437-1441.
ABSTRACT
| FULL TEXT
Dying from heart failure in hospital: palliative decision making analysis
Formiga et al.
Heart 2002;88:187-187.
FULL TEXT
A randomized trial of the efficacy of multidisciplinary care in heart failure outpatients at high risk of hospital readmission
Kasper et al.
J Am Coll Cardiol 2002;39:471-480.
ABSTRACT
| FULL TEXT
Failing ageing hearts
Petrie et al.
Eur Heart J 2001;22:1978-1990.
Depressive symptoms and risk of functional decline and death in patients with heart failure
Vaccarino et al.
J Am Coll Cardiol 2001;38:199-205.
ABSTRACT
| FULL TEXT
Effects of Angiotensin-Converting Enzyme Inhibitors and Digoxin on Health Outcomes of Very Old Patients With Heart Failure
Gambassi et al.
Arch Intern Med 2000;160:53-60.
ABSTRACT
| FULL TEXT
Relationship between psychological profile and cardiological variables in chronic heart failure. The role of patient subjectivity
Majani et al.
Eur Heart J 1999;20:1579-1586.
ABSTRACT
|