Document Detail


Determinants of long-term survival in patients hospitalized for heart failure.
MedLine Citation:
PMID:  19809351     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Current models used to stratify patients with heart failure are complex, difficult to use, and limited by short follow-up and patient selection. Our aim was to determine predictors of long-term survival in patients hospitalized for heart failure and to develop a simple mortality risk score to estimate long-term mortality. METHODS: We prospectively followed up, during 10 years after hospitalization, 701 patients with confirmed heart failure from the HOLA (Heart failure: Observation of Local Admissions) registry. RESULTS: Mean age was 72.4 +/- 11.7 years; 45% were men. During follow-up, 465 patients died and 5 underwent heart transplantation. A total of 231 patients (33%) were alive and transplant-free at the end of follow-up (5.2 +/- 4.2 years). Median survival was 3.2 years. Multivariate analysis showed that six variables (age, previous renal disease, previous stroke, chronic obstructive pulmonary disease, left ventricular ejection fraction and aortic stenosis) were independent predictors of shorter survival time. By dichotomizing these variables, we obtained six factors with similar predictive values (hazard ratio between 1.5 and 2.0). A risk score for mortality was developed using these predictors by assigning 1 point to each and adding the total for each patient. Median survival for patients with 0, 1, 2, and 3 or more points were 6.5, 5.5, 3.3, and 1.7 years, respectively. One-year mortality rates were 15, 20, 28, and 49%, respectively. CONCLUSION: The prognosis of patients hospitalized with heart failure is highly variable. A simple risk score, based on six variables readily obtainable on admission can effectively stratify patients according to their predicted mortality.
Authors:
Manuel Mart?nez-Sell?s; Esther Mart?nez; Marcelino Cort?s; Raquel Prieto; Laura Gallego; Francisco Fern?ndez-Avil?s
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-9     Citation Subset:  IM    
Affiliation:
Cardiology Department, Hospital General Universitario Gregorio Mara??n, Madrid, Spain. mmselles@secardiologia.es
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Aortic Valve Stenosis / mortality
Female
Follow-Up Studies
Health Status Indicators*
Heart Failure / mortality*,  physiopathology,  ultrasonography
Hospitalization / statistics & numerical data*
Humans
Kaplan-Meiers Estimate
Kidney Diseases / mortality
Male
Middle Aged
Prognosis
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive / mortality
Registries
Risk Assessment
Risk Factors
Stroke / mortality
Stroke Volume
Survivors / statistics & numerical data*
Time Factors
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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