“Our findings show that hospitalization due to worsening heart failure, often thought to be due to non-adherence to regimens of salt or fluid restriction, or prescribed medications, may also represent progression of disease,” said Ali Ahmed, M.D., MPH, associate professor in the division of gerontology, geriatrics and palliative care medicine and director of UAB’s Geriatric Heart Failure Clinic and the study’s lead investigator. “New strategies are needed to better manage heart failure before the disease progresses to a point where hospitalization is required.”
Hospitalization due to heart failure is the leading cause of hospitalization among older adults, and with the aging of the baby boomers, the number of heart failure patients and heart failure hospitalizations are projected to double over the next couple of decades. Ahmed’s group studied 7,788 patients enrolled in the Digitalis Investigation Group, a large clinical trial of heart failure patients conducted in 302 centres in the United States and Canada from 1991-1993.
Ahmed and colleagues found that compared to patients who had no hospitalization due to worsening heart failure during two years after randomization, those with heart failure hospitalization had about 150 percent increase in the risk of subsequent death from all causes, occurring after the first two years. The risk of death due to cardiovascular causes increased by 188 percent and that due to progressive heart failure increased by 422 percent.
“Clinicians should focus on the prevention of heart failure hospitalization in ambulatory chronic heart failure patients and once a heart failure patient is hospitalized, on improving post-discharge outcomes including re-hospitalization and mortality,” says Ahmed. “This could be achieved by the use of evidence-based therapy, patient education, and research to develop new strategies to prevent hospital admission and improve post-discharge outcomes.”
MEDICA.de; Source: University of Alabama at Birmingham