TY - JOUR

T1 - Incidence and predictors of hospitalization or death in patients managed in multidisciplinary heart failure clinics

AU - Gustafsson, Finn

AU - Schou, Morten

AU - Videbaek, Lars

AU - Dridi, Nadia

AU - Ryde, Henrik

AU - Handberg, Jens

AU - Hildebrandt, Per R

AU - Gustafsson, Finn

AU - Ryde, Henrik

AU - Danish Heart Failure Clinics Network, null

N1 - Keywords: Aged; Aged, 80 and over; Denmark; Female; Follow-Up Studies; Heart Failure; Hospital Mortality; Hospitalization; Hospitals, General; Humans; Male; Prognosis; Proportional Hazards Models; Prospective Studies; Stroke Volume; Survival Rate; Systole; Time Factors; Ventricular Dysfunction, Left; Ventricular Function, Left

PY - 2009

Y1 - 2009

N2 - AIMS: To assess the rates of death or hospitalization in outpatients with heart failure (HF) followed in multidisciplinary, nurse-based HF clinics and to compare the rates with published data from the literature. A second aim was to identify risk factors for death or hospital admission. METHODS AND RESULTS: A total of 4012 consecutive outpatients referred for HF management in 18 Danish HF clinics were included. Clinical data were collected prospectively. Outcome data were obtained from a validated, national registry. Mean follow-up time was 580 days. The mean age of patients was 69 years, 83% had left ventricular systolic dysfunction and 52% had been hospitalized within 90 days prior to referral to the HF clinic. The 6 and 12 month rates of hospitalization or death were 31 and 42%. Hospitalization or death was significantly predicted by age 1.12 (1.05-1.19), diabetes 1.21 (1.03-1.42), serum creatinine 1.03 (1.02-1.04), NYHA III and IV 1.32 (1.15-1.52), and hospitalization prior to referral to the HF clinic 1.81 (1.57-2.08). CONCLUSIONS: Event rates in this cohort were lower than most published data from HF clinic populations. Factors such as advanced age, NYHA class, and prior hospitalization predict poor outcome in patients managed in multidisciplinary HF clinics.

AB - AIMS: To assess the rates of death or hospitalization in outpatients with heart failure (HF) followed in multidisciplinary, nurse-based HF clinics and to compare the rates with published data from the literature. A second aim was to identify risk factors for death or hospital admission. METHODS AND RESULTS: A total of 4012 consecutive outpatients referred for HF management in 18 Danish HF clinics were included. Clinical data were collected prospectively. Outcome data were obtained from a validated, national registry. Mean follow-up time was 580 days. The mean age of patients was 69 years, 83% had left ventricular systolic dysfunction and 52% had been hospitalized within 90 days prior to referral to the HF clinic. The 6 and 12 month rates of hospitalization or death were 31 and 42%. Hospitalization or death was significantly predicted by age 1.12 (1.05-1.19), diabetes 1.21 (1.03-1.42), serum creatinine 1.03 (1.02-1.04), NYHA III and IV 1.32 (1.15-1.52), and hospitalization prior to referral to the HF clinic 1.81 (1.57-2.08). CONCLUSIONS: Event rates in this cohort were lower than most published data from HF clinic populations. Factors such as advanced age, NYHA class, and prior hospitalization predict poor outcome in patients managed in multidisciplinary HF clinics.

U2 - 10.1093/eurjhf/hfp025

DO - 10.1093/eurjhf/hfp025

M3 - Journal article

C2 - 19234309

VL - 11

SP - 413

EP - 419

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1567-4215

IS - 4

ER -