OBJECTIVE: To identify factors available to general practitioners (GPs) that are predictive of mortality within a general practice-based population of heart failure patients, and to report the sensitivity and specificity of prognostic information from GPs. METHODS: Five hundred and forty-two heart failure patients aged >60 years were recruited from 16 UK GP surgeries. Patients completed quality-of-life and services use questionnaires every 3 months for 24 months or until death. Factors with independent significant association with survival were identified using Cox proportional hazards regression analysis. RESULTS: Women had a 58% lower risk of death. Patients self-reporting New York Heart Association Classification III or IV had an 81% higher risk of death. Patients aged 85+ years had over a five-fold risk of death as compared with those aged <65 years. Patients with a co-morbidity of cancer had a 78% higher risk of death. Of the 14 patients who died in a 12-month period, the GPs identified 11 (sensitivity 79%). They identified 133 of the 217 who did not die (specificity 61%). DISCUSSION: Predictors readily available to GPs, such as patient characteristics, are easy to adapt to use in general practice, where most heart failure patients are diagnosed and treated. Identifying factors likely to influence death is useful in primary care, as this can initiate discussion about end-of-life care.
OBJECTIVE: To identify factors available to general practitioners (GPs) that are predictive of mortality within a general practice-based population of heart failurepatients, and to report the sensitivity and specificity of prognostic information from GPs. METHODS: Five hundred and forty-two heart failurepatients aged >60 years were recruited from 16 UK GP surgeries. Patients completed quality-of-life and services use questionnaires every 3 months for 24 months or until death. Factors with independent significant association with survival were identified using Cox proportional hazards regression analysis. RESULTS:Women had a 58% lower risk of death. Patients self-reporting New York Heart Association Classification III or IV had an 81% higher risk of death. Patients aged 85+ years had over a five-fold risk of death as compared with those aged <65 years. Patients with a co-morbidity of cancer had a 78% higher risk of death. Of the 14 patients who died in a 12-month period, the GPs identified 11 (sensitivity 79%). They identified 133 of the 217 who did not die (specificity 61%). DISCUSSION: Predictors readily available to GPs, such as patient characteristics, are easy to adapt to use in general practice, where most heart failurepatients are diagnosed and treated. Identifying factors likely to influence death is useful in primary care, as this can initiate discussion about end-of-life care.
Authors: Kei Ouchi; Guru Jambaulikar; Naomi R George; Wanlu Xu; Ziad Obermeyer; Emily L Aaronson; Jeremiah D Schuur; Mara A Schonberg; James A Tulsky; Susan D Block Journal: J Palliat Med Date: 2017-08-28 Impact factor: 2.947
Authors: Joshua R Lakin; Margaret G Robinson; Ziad Obermeyer; Brian W Powers; Susan D Block; Rebecca Cunningham; Joseph M Tumblin; Christine Vogeli; Rachelle E Bernacki Journal: J Gen Intern Med Date: 2019-06-12 Impact factor: 5.128
Authors: Ebun A Abarshi; Michael A Echteld; Lieve Van den Block; Gé A Donker; Luc Deliens; Bregje D Onwuteaka-Philipsen Journal: Br J Gen Pract Date: 2011-06 Impact factor: 5.386
Authors: Elizabeth J Lilley; Sean A Gemunden; Gentian Kristo; Navin Changoor; John W Scott; Elizabeth Rickerson; Naomi Shimizu; Ali Salim; Zara Cooper Journal: J Palliat Med Date: 2016-11-01 Impact factor: 2.947
Authors: Raya E Kheirbek; Ross D Fletcher; Marie A Bakitas; Gregg C Fonarow; Sridivya Parvataneni; Donna Bearden; Frank A Bailey; Charity J Morgan; Steven Singh; Marc R Blackman; Michael R Zile; Kanan Patel; Momanna B Ahmed; Rodney O Tucker; Cynthia J Brown; Thomas E Love; Wilbert S Aronow; Jeffrey M Roseman; Michael W Rich; Richard M Allman; Ali Ahmed Journal: Circ Heart Fail Date: 2015-05-27 Impact factor: 8.790