Mortality and Readmission Following Hospitalisation for Heart Failure in Australia: A Systematic Review and Meta-Analysis

Al-Omary, M.; Davies, Allan; Evans, Tiffany‐Jane; Bastian, B.; Fletcher, Peter; Attia, John; Boyle, Andrew

doi:10.1016/j.hlc.2018.01.009

Cited by 42 publications

(26 citation statements)

References 44 publications

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“…Outcomes for patients diagnosed with HF were poor in northern Tanzania, with a 30-day mortality rate of 25%, similar to recent studies from elsewhere in SSA [17,18,32]. The mortality rates observed in SSA are much higher than what has been reported outside of SSA [33][34][35]: in the United States, for example, the 30-day mortality rate following ED presentation for HF is between 4 and 12 percent [36]. The higher mortality rate in Tanzania might be partly due to the low uptake of recommended HF therapies both before and following the ED visit.…”

Section: Plos Onesupporting

confidence: 76%

Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study

et al. 2021

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Background The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. Methods In a prospective observational study, adult patients presenting with shortness of breath or chest pain to an emergency department in northern Tanzania were consecutively enrolled. Participants with a physician-documented clinical diagnosis of heart failure were included in the present analysis. Standardized questionnaires regarding medical history and medication use were administered at enrollment, and treatments given in the emergency department were recorded. Thirty days after enrollment, a follow-up questionnaire was administered to assess mortality and medication use. Multivariate logistic regression was performed to identify baseline predictors of thirty-day mortality. Results Of 1020 enrolled participants enrolled from August 2018 through October 2019, 267 patients (26.2%) were diagnosed with heart failure. Of these, 139 (52.1%) reported a prior history of heart failure, 168 (62.9%) had self-reported history of hypertension, and 186 (69.7%) had NYHA Class III or IV heart failure. At baseline, 40 (15.0%) reported taking a diuretic and 67 (25.1%) reported taking any antihypertensive. Thirty days following presentation, 63 (25.4%) participants diagnosed with heart failure had died. Of 185 surviving participants, 16 (8.6%) reported taking a diuretic, 24 (13.0%) reported taking an antihypertensive, and 26 (14.1%) were rehospitalized. Multivariate predictors of thirty-day mortality included self-reported hypertension (OR = 0.42, 95% CI: 0.21–0.86], p = 0.017) and symptomatic leg swelling at presentation (OR = 2.69, 95% CI: 1.35–5.56, p = 0.006). Conclusion In a northern Tanzanian emergency department, heart failure is a common clinical diagnosis, but uptake of evidence-based outpatient therapies is poor and thirty-day mortality is high. Interventions are needed to improve care and outcomes for heart failure patients in the emergency department setting.

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Section: Plos Onesupporting

confidence: 76%

Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study

et al. 2021

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“…However, there has been no further reduction in mortality observed since the late 1990s with 1‐year mortality remaining high at 23% in Australia 15 and 28% in New Zealand 17 . One‐year all‐cause readmission rates are 56% 40 and almost 20 days spent are hospital in the year following heart failure diagnosis 17 …”

Section: Heart Failure In Australia and New Zealandmentioning

confidence: 99%

“…However, there has been no further reduction in mortality observed since the late 1990s with 1-year mortality remaining high at 23% in Australia 15 and 28% in New Zealand. 17 Oneyear all-cause readmission rates are 56% 40 and almost 20 days spent are hospital in the year following heart failure diagnosis. 17 The healthcare burden of heart failure in New Zealand is likely to be underestimated, as the above studies have limited case identification to hospital discharges only.…”

Section: Heart Failure In Australia and New Zealandmentioning

confidence: 99%

Temporal trends in the burden of heart failure

Chan

Kerr

Doughty

2021

Internal Medicine Journal

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Heart failure is a common healthcare problem associated with high morbidity and mortality. The burden of heart failure is changing; increases secondary to an ageing population may be offset by improved primary cardiovascular prevention and advances in heart failure therapies. In this review, we evaluate recent international trends in heart failure incidence, morbidity and mortality. Although the age‐standardised incidence of heart failure has been decreasing since 2000, the incidence in those age groups <55 years is increasing with patients being diagnosed at younger ages. Despite improvements in therapies for heart failure, prognosis still remains poor with up to one‐third of patients not surviving beyond 1 year following diagnosis and no improvements in mortality over the past 10 years. The case‐mix of heart failure patients is changing with a greater proportion having non‐ischaemic aetiology and preserved ejection fraction, and a higher prevalence of non‐cardiovascular comorbidity and mortality.

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“…Furthermore, it is currently expected that around 8 million adults will be diagnosed with heart failure by 2030[2]. The estimated all-cause mortality rate for heart failure is 8% and 25% for 30-d and 1-year periods, respectively[3]. Moreover, elderly heart failure patients face high rates of comorbidities and hospital readmissions[4].…”

Section: Introductionmentioning

confidence: 99%

Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trails

Wang

Yeh

2019

WJCC

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BACKGROUNDPrior studies indicate that doing breathing exercises improves physical performance and quality of life (QoL) in heart failure patients. However, these effects remain unclear and contradictory.AIMTo determine the effects of machine-assisted and non-machine-assisted respiratory training on physical performance and QoL in heart failure patients.METHODSThis was a systematic review and network meta-analysis study. A literature search of electronic databases was conducted for randomized controlled trials (RCTs) on heart failure. Respiratory training interventions were grouped as seven categories: IMT_Pn (inspiratory muscle training without pressure or < 10% maximal inspiratory pressure, MIP), IMT_Pl (inspiratory muscle training with low pressure, 10%-15% MIP), IMT_Pm (inspiratory muscle training with medium pressure, 30%-40% MIP), IMT_Ph (inspiratory muscle training with high pressure, 60% MIP or MIP plus aerobics), Aerobics (aerobic exercise or weight training), Qi_Ex (tai chi, yoga, and breathing exercise), and none. The four outcomes were heart rate, peak oxygen uptake (VO2 peak), 6-min walking distance test (6MWT), and Minnesota Living with Heart Failure QoL. The random-effects model, side-splitting model, and the surface under the cumulative ranking curve (SUCRA) were used to test and analyze the data.RESULTSA total of 1499 subjects from 31 RCT studies were included. IMT_Ph had the highest effect sizes for VO2 peak and 6MWT, IMT_Pm highest for QoL, and Qi_Ex highest for heart rate. Aerobics had the second highest for VO2 peak, Qi_Ex second highest for 6MWT, and IMT_Ph second highest for heart rate and QoL.CONCLUSIONThis study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients. After hospital discharge, non-machine-assisted training continuously improves cardiac function.

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Mortality and Readmission Following Hospitalisation for Heart Failure in Australia: A Systematic Review and Meta-Analysis

Cited by 42 publications

References 44 publications

Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study

Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study

Temporal trends in the burden of heart failure

Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trails

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