Bertram Pitt, MD
What are the frequency and causes of hospitalization after diagnosis of heart failure? Which factors are associated with hospitalization?
Inception cohort followed for a mean 4.7 years.
Olmsted County, Minnesota, USA.
1077 patients (mean age 77 y, 54 % women) with a first diagnosis of heart failure (based on Framingham criteria).
Age, sex, ejection fraction ≥ 50%, hypertension, diabetes mellitus, current smoking, previous myocardial infarction, chronic obstructive pulmonary disease (COPD), peripheral vascular disease, cerebrovascular disease, body mass index, anemia, creatinine clearance, and year of diagnosis.
Hospitalizations after diagnosis of heart failure.
By the end of follow-up, 74% of patients had died. 83% of patients had ≥ 1 hospitalization after diagnosis; 67%, 54%, and 43% had ≥ 2, ≥ 3, and ≥ 4 hospitalizations, respectively. Mean rate of hospitalization was 0.87 times per year. 17% of hospitalizations were due to heart failure, 22% were due to other cardiovascular causes, and 62% were due to noncardiovascular causes. Independent predictors of hospitalization were male sex, diabetes, COPD, anemia, and creatinine clearance < 30 mL/min (Table). Independent predictors of a first hospitalization for heart failure were diabetes and creatinine clearance 30 to < 60 mL/min.
83% of patients had ≥ 1 hospitalization after diagnosis of heart failure; most were due to noncardiovascular causes. Independent predictors of hospitalization were male sex, diabetes, chronic obstructive lung disease, anemia, and creatinine clearance < 30 mL/min.
Factors independently associated with hospitalization at a mean 4.7 years after diagnosis of heart failure*
*CI defined in Glossary. Based on multivariate analysis.
Pitt B. Male gender, diabetes, COPD, anemia, and creatinine clearance < 30 mL/min predicted hospitalization after heart failure diagnosis. Ann Intern Med. 2010;152:JC4–2. doi: 10.7326/0003-4819-152-8-201004200-02002
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Published: Ann Intern Med. 2010;152(8):JC4-2.
Cardiology, Chronic Obstructive Airway Disease, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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