Candace D McNaughton1,2, Alex McConnachie3, John G Cleland3, John A Spertus4, Christiane E Angermann5, Patrycja Duklas3, Jasper Tromp6, Carolyn S P Lam7, Gerasimos Filippatos8, Ulf Dahlstrom9, Kenneth Dickstein10, Anja Schweizer11, Sergio V Perrone12, Mahmoud Hassanein13, Georg Ertl5, Achim Obergfell14, Mathieu Ghadanfar15, Sean P Collins2,16. 1. ICES, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada. 2. Vanderbilt University Medical Center, Nashville, TN, USA. 3. Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. 4. Saint Luke's Mid America Heart Institute/University of Missouri -, Kansas City, MO, USA. 5. Comprehensive Heart Failure Center, University Hospital, Department of Medicine-Cardiology University of Würzburg, Würzburg, Germany. 6. Saw Swee Hock School of Public Health, National University of Singapore, The National University Health System, Singapore. 7. National Heart Centre Singapore, Singapore; Cardiovascular Academic Clinical Program, Duke-National University of Singapore, Singapore. 8. University of Cyprus School of Medicine, Cyprus, Greece. 9. Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. 10. University of Bergen, Stavanger University Hospital, Stavanger, Norway. 11. Novartis Pharma AG, Basel, Switzerland. 12. Hospital El Cruce Hospital Florencio Varela; FLENI Institute and Argentine Institute of Diagnosis and Treatment, Argentine Catholic University, Buenos Aires, Argentina. 13. Alexandria University, Alexandria, Egypt. 14. Vifor Pharma AG, Glattbrugg, Switzerland. 15. M-Ghadanfar Consulting (Life Sciences), Basel, Switzerland. 16. Geriatric Research and Education Clinical Care, Tennessee Valley Healthcare Facility VA Medical Center, Nashville, TN, USA.
Abstract
AIMS: Recovery of well-being after hospitalisation for acute heart failure (AHF) is a measure of the success of interventions and the quality of care but has rarely been quantified. Accordingly, we measured health status after discharge in an international registry (REPORT-HF) of AHF. METHODS AND RESULTS: The analysis included 4606 patients with AHF who survived to hospital discharge, had known vital status at 6 months, and were enrolled in the United States of America, Russian Federation, or Western Europe, where the Kansas City Cardiomyopathy Questionnaire (KCCQ) was administered. Median age was 69 years (quartiles 59-78), 40% were women, and 34% had a left ventricular ejection fraction (LVEF) <40%, and 12% patients died by 6 months. Of 2475 patients with a follow-up KCCQ, 28% were 'alive and well' (KCCQ >75), while 43% had poor health status (KCCQ ≤50). Being 'alive and well' was associated with new-onset AHF, LVEF <40%, younger age, higher baseline KCCQ, country, and race. Associations were similar for increasing health status, with the exception of country and addition of comorbidities. CONCLUSION: In this international global registry, health status recovery after AHF hospitalisation was highly variable. Those with the best health status at 6 months were younger, had new-onset heart failure, and higher baseline KCCQ; nearly one-third of survivors were 'alive and well'. Investigating reasons for changes in KCCQ after hospitalisation might identify new therapeutic targets to improve patient-centred outcomes.
AIMS: Recovery of well-being after hospitalisation for acute heart failure (AHF) is a measure of the success of interventions and the quality of care but has rarely been quantified. Accordingly, we measured health status after discharge in an international registry (REPORT-HF) of AHF. METHODS AND RESULTS: The analysis included 4606 patients with AHF who survived to hospital discharge, had known vital status at 6 months, and were enrolled in the United States of America, Russian Federation, or Western Europe, where the Kansas City Cardiomyopathy Questionnaire (KCCQ) was administered. Median age was 69 years (quartiles 59-78), 40% were women, and 34% had a left ventricular ejection fraction (LVEF) <40%, and 12% patients died by 6 months. Of 2475 patients with a follow-up KCCQ, 28% were 'alive and well' (KCCQ >75), while 43% had poor health status (KCCQ ≤50). Being 'alive and well' was associated with new-onset AHF, LVEF <40%, younger age, higher baseline KCCQ, country, and race. Associations were similar for increasing health status, with the exception of country and addition of comorbidities. CONCLUSION: In this international global registry, health status recovery after AHF hospitalisation was highly variable. Those with the best health status at 6 months were younger, had new-onset heart failure, and higher baseline KCCQ; nearly one-third of survivors were 'alive and well'. Investigating reasons for changes in KCCQ after hospitalisation might identify new therapeutic targets to improve patient-centred outcomes.