BACKGROUND: Heart failure (HF) is a major issue of public health in contemporary aging populations. The objectives of the present study were to assess the long-term survival of a contemporary cohort of patients discharged after a first hospitalization for HF and identify variables associated with adverse outcome. METHODS: We prospectively included consecutive patients (n=735) discharged from 11 healthcare establishments of the Somme department (France) after a first hospitalization for HF during 2000. The 7-year observed survival was compared with the expected survival of the general population. RESULTS: Mean age of the study group was 75+/-12 years and 48% of patients were women. Left ventricular ejection fraction was measured in 628 patients (85%). During the 7-year follow-up, 483 patients (67%) died. The 5- and 7-year observed survival rates were dramatically lower than the expected survival of the matched general population (42% vs. 70%, and 33% vs. 59%, respectively). Relative survival (observed/expected survival) was 60% at 5 years and 55% at 7 years. Multivariable analysis identified cancer, stroke, diabetes, prior myocardial infarction, chronic obstructive pulmonary disease, chronic atrial fibrillation, age, and hyponatraemia as independent predictors of 7-year mortality. CONCLUSIONS: In Europe, the long-term outcome of patients with new-onset HF is still extremely poor. Better implementation of guideline-oriented therapeutic strategies is needed to improve prognosis of this increasingly prevalent condition. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
BACKGROUND:Heart failure (HF) is a major issue of public health in contemporary aging populations. The objectives of the present study were to assess the long-term survival of a contemporary cohort of patients discharged after a first hospitalization for HF and identify variables associated with adverse outcome. METHODS: We prospectively included consecutive patients (n=735) discharged from 11 healthcare establishments of the Somme department (France) after a first hospitalization for HF during 2000. The 7-year observed survival was compared with the expected survival of the general population. RESULTS: Mean age of the study group was 75+/-12 years and 48% of patients were women. Left ventricular ejection fraction was measured in 628 patients (85%). During the 7-year follow-up, 483 patients (67%) died. The 5- and 7-year observed survival rates were dramatically lower than the expected survival of the matched general population (42% vs. 70%, and 33% vs. 59%, respectively). Relative survival (observed/expected survival) was 60% at 5 years and 55% at 7 years. Multivariable analysis identified cancer, stroke, diabetes, prior myocardial infarction, chronic obstructive pulmonary disease, chronic atrial fibrillation, age, and hyponatraemia as independent predictors of 7-year mortality. CONCLUSIONS: In Europe, the long-term outcome of patients with new-onset HF is still extremely poor. Better implementation of guideline-oriented therapeutic strategies is needed to improve prognosis of this increasingly prevalent condition. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
Authors: I Vaartjes; A W Hoes; J B Reitsma; A de Bruin; D E Grobbee; A Mosterd; M I Bots Journal: BMC Public Health Date: 2010-10-22 Impact factor: 3.295