One-year Follow-Up of Heart Failure Patients After Their First Admission

QJM. 2004 Feb;97(2):81-6. doi: 10.1093/qjmed/hch018.

Abstract

Background: Outcomes related to heart failure remain relatively poor.

Aim: To examine the clinical course of patients for one year after their first admission because of heart failure, including prognosis, mortality, and rehospitalization.

Design: Prospective observational study.

Methods: Of 121 patients hospitalized over 6 months for decompensation of previously unknown heart failure, we excluded those with a possible previous diagnosis of heart failure (n = 5), who suffered from another serious disease with a poor prognosis (n = 6), died during the index hospitalization (n = 5), refused to participate (n = 4) or were lost to follow-up (n = 6). Mortality and readmissions were identified by prospective follow-up of all patients.

Results: Of the 98 patients evaluated, half (49) were women. Mean +/- SD age was 75.2 +/- 12 years. The 1-year case-fatality rate after the first admission was 24%; 19% of the deaths were heart failure-related, with progressive pump failure the predominant cause (14% of the total). Age was the only factor associated with increased mortality (p < 0.007). Of the 74 survivors, 32% experienced at least one hospital readmission during follow-up.

Discussion: The prognosis of unselected new cases of heart failure after their first hospitalization remains relatively poor, despite recent advances in pharmacological therapy and medical care.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Heart Failure / mortality*
  • Heart Failure / therapy
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Prognosis
  • Prospective Studies
  • Spain / epidemiology