Epidemiology and practice patterns of acute decompensated heart failure

Munger, Mark; Carter, Orly

doi:10.1093/ajhp/60.suppl_4.s3

Cited by 7 publications

(3 citation statements)

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“…A total of 183 variables were entered into the analysis with 31 significantly associated with total hospital cost in the final model (Table 2). The mean age of the sample was 72.7 years, consistent with other studies (Munger and Carter 2003). A younger age was significantly associated with greater cost with initial bivariate analysis ( p =.005), also consistent with other reports (Wexler et al 2001), but when other patient characteristics variables were added, this association disappeared.…”

Section: Resultssupporting

confidence: 90%

Cost of Hospital Care for Older Adults with Heart Failure: Medical, Pharmaceutical, and Nursing Costs

Titler

Jensen

Dochterman

et al. 2007

Health Services Research

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Objective. To determine the impact of patient characteristics, clinical conditions, hospital unit characteristics, and health care interventions on hospital cost of patients with heart failure. Data Sources/Study Setting. Data for this study were part of a larger study that used electronic clinical data repositories from an 843-bed, academic medical center in the Midwest. Study Design. This retrospective, exploratory study used existing administrative and clinical data from 1,435 hospitalizations of 1,075 patients 60 years of age or older. A cost model was tested using generalized estimating equations (GEE) analysis. Data Collection/Extraction Methods. Electronic databases used in this study were the medical record abstract, the financial data repository, the pharmacy repository; and the Nursing Information System repository. Data repositories were merged at the patient level into a relational database and housed on an SQL server. Principal Findings. The model accounted for 88 percent of the variability in hospital costs for heart failure patients 60 years of age and older. The majority of variables that were associated with hospital cost were provider interventions. Each medical procedure increased cost by $623, each unique medication increased cost by $179, and the addition of each nursing intervention increased cost by $289. One medication and several nursing interventions were associated with lower cost. Nurse staffing below the average and residing on 2-4 units increased hospital cost. Conclusions. The model and data analysis techniques used here provide an innovative and useful methodology to describe and quantify significant health care processes and their impact on cost per hospitalization. The findings indicate the importance of conducting research using existing clinical data in health care.

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Section: Resultssupporting

confidence: 90%

Cost of Hospital Care for Older Adults with Heart Failure: Medical, Pharmaceutical, and Nursing Costs

Titler

Jensen

Dochterman

et al. 2007

Health Services Research

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“…In recent years, the large-scale registries published worldwide that focus on AHF primarily include the the Acute Decompensated Heart Failure National Registry (ADHERE) study [15][16][17][18] and the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) study [19] from the United States, the European Society of Cardiology Heart Failure (ESC-HF) Pilot study from Europe, [20] the ADHERE-Asia Pacific (AP) study for the Asia Pacific region, [21] the EFICA study from France, [22] the Italian Network on Heart Failure (IN-HF) study from Italy, [23] and the Acute Decompensated Heart Failure Syndromes Registry (AT-TEND) study from Japan, [4] and they provide us with a real-world picture of the evaluation, management, and survival status of AHF patients. However, most of these studies selected hospitalized patients as the study population, and primarily focused on short-or intermediate-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes and independent predictors of mortality in patients presenting to emergency departments with acute heart failure in Beijing: a multicenter cohort study with a 5-year follow-up

Yang

Sun

Qiu

et al. 2021

Chinese Medical Journal

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Background: Acute heart failure (AHF) is the most common disease in emergency departments (EDs). However, clinical data exploring the outcomes of patients presenting AHF in EDs are limited, especially the long-term outcomes. The purposes of this study were to describe the long-term outcomes of patients with AHF in the EDs and further analyze their prognostic factors. Methods: This prospective, multicenter, cohort study consecutively enrolled 3335 patients with AHF who were admitted to EDs of 14 hospitals from Beijing between January 1, 2011 and September 23, 2012. Kaplan-Meier and Cox regression analysis were adopted to evaluate 5-year outcomes and associated predictors. Results: The 5-year mortality and cardiovascular death rates were 55.4% and 49.6%, respectively. The median overall survival was 34 months. Independent predictors of 5-year mortality were patient age (hazard ratio [HR]: 1.027, 95 confidence interval [CI]: 1.023–1.030), body mass index (BMI) (HR: 0.971, 95% CI: 0.958–0.983), fatigue (HR: 1.127, 95% CI: 1.009–1.258), ascites (HR: 1.190, 95% CI: 1.057–1.340), hepatic jugular reflux (HR: 1.339, 95% CI: 1.140–1.572), New York Heart Association (NYHA) class III to IV (HR: 1.511, 95% CI: 1.291–1.769), heart rate (HR: 1.003, 95% CI: 1.001–1.005), diastolic blood pressure (DBP) (HR: 0.996, 95% CI: 0.993–0.999), blood urea nitrogen (BUN) (HR: 1.014, 95% CI: 1.008–1.020), B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in the third (HR: 1.426, 95% CI: 1.220–1.668) or fourth quartile (HR: 1.437, 95% CI: 1.223–1.690), serum sodium (HR: 0.980, 95% CI: 0.972–0.988), serum albumin (HR: 0.981, 95% CI: 0.971–0.992), ischemic heart diseases (HR: 1.195, 95% CI: 1.073–1.331), primary cardiomyopathy (HR: 1.382, 95% CI: 1.183–1.614), diabetes (HR: 1.118, 95% CI: 1.010–1.237), stroke (HR: 1.252, 95% CI: 1.121–1.397), and the use of diuretics (HR: 0.714, 95% CI: 0.626–0.814), β-blockers (HR: 0.673, 95% CI: 0.588–0.769), angiotensin-converting enzyme inhibitors (ACEIs) (HR: 0.714, 95% CI: 0.604–0.845), angiotensin-II receptor blockers (ARBs) (HR: 0.790, 95% CI: 0.646–0.965), spironolactone (HR: 0.814, 95% CI: 0.663–0.999), calcium antagonists (HR: 0.624, 95% CI: 0.531–0.733), nitrates (HR: 0.715, 95% CI: 0.631–0.811), and digoxin (HR: 0.579, 95% CI: 0.465–0.721). Conclusions: The results of our study demonstrate poor 5-year outcomes of patients presenting to EDs with AHF. Age, BMI, fatigue, ascites, hepatic jugular reflux, NYHA class III to IV, heart rate, DBP, BUN, BNP/NT-proBNP level in the third or fourth quartile, serum sodium, serum albumin, ischemic heart diseases, primary cardiomyopathy, diabetes, stroke, and the use of diuretics, β-blockers, ACEIs, ARBs, spironolactone, calcium antagonists, nitrates, and digoxin were independently associated with 5-year all-cause mortality.

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“…3 Even after excluding patients with shock, several recent studies indicate that the rate of the composite endpoint of death or re-hospitalization at 60-days post discharge is consistently >30% among patients hospitalized for AHFS. 4-6 Though studies have identified some patient characteristics affecting the risk of this composite endpoint, no widely accepted risk prediction model has emerged to date.…”

Section: Importance Of Hospitalization For Acute Hf Syndrome (Ahfs)mentioning

confidence: 99%

GLP-1 Agonist Therapy for Advanced Heart Failure With Reduced Ejection Fraction

Margulies

Anstrom

Hernandez

et al. 2014

Circ: Heart Failure

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Epidemiology and practice patterns of acute decompensated heart failure

Cited by 7 publications

References 0 publications

Cost of Hospital Care for Older Adults with Heart Failure: Medical, Pharmaceutical, and Nursing Costs

Cost of Hospital Care for Older Adults with Heart Failure: Medical, Pharmaceutical, and Nursing Costs

Long-term outcomes and independent predictors of mortality in patients presenting to emergency departments with acute heart failure in Beijing: a multicenter cohort study with a 5-year follow-up

GLP-1 Agonist Therapy for Advanced Heart Failure With Reduced Ejection Fraction

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