Congestive heart failure in the community: changes in incidence and survival over a 10-year period

Senni, Michele; Tribouilloy, C; Rodeheffer, R.J.; Evans, Jeff; Jacobsen, S.J.; Bailey, K.R.; Redfield, M. M.

doi:10.1016/s0735-1097(98)80282-9

Cited by 31 publications

(42 citation statements)

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“…These clinics do not accept patients who are cognitively impaired or are unable to attend appointments regularly, which may explain the mean age of the patients (65 years), and is considerably younger than the average age of 75 years in epidemiological studies (25,31,32). In Montreal, in 1999, 85% of the hospitalizations for CHF were for people 65 years of age and older (33).…”

Section: Discussionmentioning

confidence: 99%

Are there sex-related differences in specialized, multidisciplinary congestive heart failure clinics?

Houde

Feldman

Pilote

et al. 2007

Canadian Journal of Cardiology

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C ongestive heart failure (CHF) is the most common cause of hospital admissions in people 65 years of age and older (1). Women represent more than one-half of these CHF hospitalizations (2); thus, it is important to determine whether there are sex-related inequities in the referral and follow-up of CHF patients. A sex-related bias in access to services has been documented in coronary artery disease (3-8) and, to a lesser extent, in CHF (9-12).In the past decade, new developments in treatment have led to improvements in CHF survival, decreased hospital admissions and improved quality of life (13,14). To implement these new treatment regimens, and to account for the growing number of cases and hospitalizations, specialized, multidisciplinary CHF clinics have been established. Benefits of these clinics include reduction in emergency room visits, hospitalization frequency and length of stay, together with reduced cost of care and improvement in quality of life; moreover, there is now some evidence to support their impact on survival (15-20). However, it is unclear whether men and women are equally enrolled in such case management programs, and whether they derive the same benefits. Thus, the purpose of the present study was to evaluate possible sex-related BACKGROUND: Specialized, multidisciplinary clinics improve service provision and reduce morbidity for patients with congestive heart failure (CHF). Although sex-related differences in access to cardiac health services have been reported, it remains unclear whether there are sex-related differences in the use of these specialized services. OBJECTIVES: To evaluate possible sex-related differences in severity at entry into specialized, multidisciplinary clinics, and compare prescription patterns between male and female patients at these clinics. METHODS: Data were obtained from the electronic clinical files of 765 CHF patients newly admitted to any of three main CHF clinics in Montreal, Quebec. Univariate and multivariate models were used to compare differences between sexes. RESULTS: Only 27.1% of patients were female. The mean age (± SD) of the women in the present study was similar to that of the men (64±16 years versus 65±13 years, respectively). Left ventricular ejection fraction at entry for patients with reduced systolic function was comparable between sexes. The New York Heart Association functional class at entry was similar among men and women with systolic dysfunction. However, among patients with preserved systolic function, women were more symptomatic, with a higher functional class at entry (adjusted OR 2.52, 95% CI 1.18 to 5.38). Prescription profiles were similar for men and women. CONCLUSION: Entry into a clinic may be delayed for women with preserved systolic function CHF. However, clinic referral patterns and disease management appeared to be similar among both men and women with systolic dysfunction CHF.

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Section: Discussionmentioning

confidence: 99%

Are there sex-related differences in specialized, multidisciplinary congestive heart failure clinics?

Houde

Feldman

Pilote

et al. 2007

Canadian Journal of Cardiology

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“…Indeed, the main findings concerning CHF in this age class derive from studies conducted in the United States; the Framingham study, 6) the Cardiovascular Health study, 12) the New Haven Connecticut cohort of the Established Population for Epidemiological Studies of the Elderly program, 13) and the experiences of Cowie, et al 10) and Senni, et al 20) have made the greatest contribution to this topic. In Europe, the data on CHF in the elderly derive from the Rotterdam Study 13) and in part from the non-population-based experience that Cowie, et al 21) reported among general practitioners of West London.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Congestive Heart Failure Mortality in Elderly People From the General Population The CArdiovascular STudy in the ELderly (CASTEL)

et al. 2005

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SUMMARYCongestive heart failure (CHF) is highly prevalent in the elderly. The aim of this study was to identify the predictors of CHF mortality in patients over 65 years of age who were free of CHF at initial screening. A total of 3,282 elderly subjects were recruited in a population-based frame and 12-year events were recorded. Continuous items were divided into tertiles and for each tertile adjusted the relative risk (RR) with 95% confidence intervals (CI) was derived in both genders from multivariate Cox analysis of CHF mortality.Age

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“…This is a quite different finding from that reported by the Framingham investigators in 1993, 9 who studied patients developing heart failure in the period 1948 to 1988, and by the Rochester investigators, who studied patients in the period 1981 to 1991. 11 In both of these studies, no temporal change in prognosis was identified. Therefore, it is clearly tempting to suggest that our more encouraging observations, from an era when ACE inhibitors have become more widely used, reflect a true improvement in survival, consequent on better treatment.…”

Section: Macintyre Et Al Improving Survival From Heart Failurementioning

confidence: 93%

“…The Rochester Epidemiology project has also described the prognosis in 107 patients presenting to associated hospitals with new-onset heart failure in 1981 and in 141 patients presenting in 1991. 11 The median follow-up in these cohorts was 1061 and 1233 days, respectively. The mean age of the 1981 patients was 75 years, rising to 77 years in 1991.…”

Section: Macintyre Et Al Improving Survival From Heart Failurementioning

confidence: 99%

Evidence of Improving Prognosis in Heart Failure

et al. 2000

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Background-Contemporary survival in unselected patients with heart failure and the population impact of newer therapies have not been widely studied. Therefore, we have documented case-fatality rates (CFRs) over a recent 10-year period. Methods and Results-In Scotland, all hospitalizations and deaths are captured on a single database. We have studied case fatality in all patients admitted with a principal diagnosis of heart failure from 1986 to 1995. A total of 66 547 patients (47% male) were studied. Although survival has increased significantly over the last decade, there is still much room for improvement.

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Congestive heart failure in the community: changes in incidence and survival over a 10-year period

Cited by 31 publications

References 0 publications

Are there sex-related differences in specialized, multidisciplinary congestive heart failure clinics?

Are there sex-related differences in specialized, multidisciplinary congestive heart failure clinics?

Predictors of Congestive Heart Failure Mortality in Elderly People From the General Population The CArdiovascular STudy in the ELderly (CASTEL)

Evidence of Improving Prognosis in Heart Failure

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