Management and outcomes of congestive heart failure: A prospective study of hospitalised patients

Julia M. Lowe, Paula M. Candlish, David A. Henry, John H. Wlodarcyk, Richard F. Heller, Peter J. Fletcher

Research output: Contribution to journalArticleResearchpeer-review

42 Citations (Scopus)

Abstract

Objectives: To characterise the morbidity, mortality and patterns of care for patients hospitalised with congestive heart failure (CHF). Design: Prospective cohort study with one-year follow-up. Patients: 409 patients aged 60 years and over admitted to hospital with congestive heart failure between 1 May and 30 November 1993. Setting: John Hunter Hospital (tertiary referral for cardiology) and Mater Hospital (non-tertiary referral for cardiology), Newcastle, New South Wales. Outcome measures: Length of hospital stay (LOS); unplanned readmissions; mortality at 28 days and one year; and relationship between outcomes and patient and disease characteristics determined by multivariate analysis. Results: Annual hospitalisation rate for CHF in the 60 years and over age group was 783/100,000, with CHF accounting for 10.9% of patients in this age group. Median LOS was eight days, and varied significantly between hospitals. ACE inhibitors were being taken by 66% of subjects at discharge. Rate of unplanned readmissions within 28 days was 20%. Mortality was 12.5% at 28 days and 33% at one year. For a first admission for CHF, 28-day mortality was lower than for readmissions (odds ratio, 0.25; 95% confidence interval, 0.1-0.62), and average LOS was 17% lower. Increasing age and renal impairment were significantly associated with higher one-year mortality. Greater comorbidity was associated significantly with longer LOS and non-significantly with higher 28-day and one-year mortality. Conclusions: CHF is a common reason for admission, often results in unplanned readmissions, and has a high mortality. Undertreatment with ACE inhibitors continues. The importance of avoiding recurrent admissions was clear. A program of intensive case management may reduce the burden attributable to CHF.

Original languageEnglish
Pages (from-to)115-118
Number of pages4
JournalMedical Journal of Australia
Volume168
Issue number3
Publication statusPublished - 2 Feb 1998
Externally publishedYes

Fingerprint

Length of Stay
Heart Failure
Prospective Studies
Mortality
Cardiology
Angiotensin-Converting Enzyme Inhibitors
Tertiary Care Centers
Age Groups
New South Wales
Case Management
Comorbidity
Patient Care
Hospitalization
Cohort Studies
Multivariate Analysis
Odds Ratio
Mothers
Outcome Assessment (Health Care)
Confidence Intervals
Morbidity

Cite this

Lowe, J. M., Candlish, P. M., Henry, D. A., Wlodarcyk, J. H., Heller, R. F., & Fletcher, P. J. (1998). Management and outcomes of congestive heart failure: A prospective study of hospitalised patients. Medical Journal of Australia, 168(3), 115-118.
Lowe, Julia M. ; Candlish, Paula M. ; Henry, David A. ; Wlodarcyk, John H. ; Heller, Richard F. ; Fletcher, Peter J. / Management and outcomes of congestive heart failure : A prospective study of hospitalised patients. In: Medical Journal of Australia. 1998 ; Vol. 168, No. 3. pp. 115-118.
@article{5101d01580e640768853fd0452a2234b,
title = "Management and outcomes of congestive heart failure: A prospective study of hospitalised patients",
abstract = "Objectives: To characterise the morbidity, mortality and patterns of care for patients hospitalised with congestive heart failure (CHF). Design: Prospective cohort study with one-year follow-up. Patients: 409 patients aged 60 years and over admitted to hospital with congestive heart failure between 1 May and 30 November 1993. Setting: John Hunter Hospital (tertiary referral for cardiology) and Mater Hospital (non-tertiary referral for cardiology), Newcastle, New South Wales. Outcome measures: Length of hospital stay (LOS); unplanned readmissions; mortality at 28 days and one year; and relationship between outcomes and patient and disease characteristics determined by multivariate analysis. Results: Annual hospitalisation rate for CHF in the 60 years and over age group was 783/100,000, with CHF accounting for 10.9{\%} of patients in this age group. Median LOS was eight days, and varied significantly between hospitals. ACE inhibitors were being taken by 66{\%} of subjects at discharge. Rate of unplanned readmissions within 28 days was 20{\%}. Mortality was 12.5{\%} at 28 days and 33{\%} at one year. For a first admission for CHF, 28-day mortality was lower than for readmissions (odds ratio, 0.25; 95{\%} confidence interval, 0.1-0.62), and average LOS was 17{\%} lower. Increasing age and renal impairment were significantly associated with higher one-year mortality. Greater comorbidity was associated significantly with longer LOS and non-significantly with higher 28-day and one-year mortality. Conclusions: CHF is a common reason for admission, often results in unplanned readmissions, and has a high mortality. Undertreatment with ACE inhibitors continues. The importance of avoiding recurrent admissions was clear. A program of intensive case management may reduce the burden attributable to CHF.",
author = "Lowe, {Julia M.} and Candlish, {Paula M.} and Henry, {David A.} and Wlodarcyk, {John H.} and Heller, {Richard F.} and Fletcher, {Peter J.}",
year = "1998",
month = "2",
day = "2",
language = "English",
volume = "168",
pages = "115--118",
journal = "Medical Journal of Australia",
issn = "0025-729X",
publisher = "AUSTRALASIAN MED PUBL CO LTD",
number = "3",

}

Lowe, JM, Candlish, PM, Henry, DA, Wlodarcyk, JH, Heller, RF & Fletcher, PJ 1998, 'Management and outcomes of congestive heart failure: A prospective study of hospitalised patients' Medical Journal of Australia, vol. 168, no. 3, pp. 115-118.

Management and outcomes of congestive heart failure : A prospective study of hospitalised patients. / Lowe, Julia M.; Candlish, Paula M.; Henry, David A.; Wlodarcyk, John H.; Heller, Richard F.; Fletcher, Peter J.

In: Medical Journal of Australia, Vol. 168, No. 3, 02.02.1998, p. 115-118.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Management and outcomes of congestive heart failure

T2 - A prospective study of hospitalised patients

AU - Lowe, Julia M.

AU - Candlish, Paula M.

AU - Henry, David A.

AU - Wlodarcyk, John H.

AU - Heller, Richard F.

AU - Fletcher, Peter J.

PY - 1998/2/2

Y1 - 1998/2/2

N2 - Objectives: To characterise the morbidity, mortality and patterns of care for patients hospitalised with congestive heart failure (CHF). Design: Prospective cohort study with one-year follow-up. Patients: 409 patients aged 60 years and over admitted to hospital with congestive heart failure between 1 May and 30 November 1993. Setting: John Hunter Hospital (tertiary referral for cardiology) and Mater Hospital (non-tertiary referral for cardiology), Newcastle, New South Wales. Outcome measures: Length of hospital stay (LOS); unplanned readmissions; mortality at 28 days and one year; and relationship between outcomes and patient and disease characteristics determined by multivariate analysis. Results: Annual hospitalisation rate for CHF in the 60 years and over age group was 783/100,000, with CHF accounting for 10.9% of patients in this age group. Median LOS was eight days, and varied significantly between hospitals. ACE inhibitors were being taken by 66% of subjects at discharge. Rate of unplanned readmissions within 28 days was 20%. Mortality was 12.5% at 28 days and 33% at one year. For a first admission for CHF, 28-day mortality was lower than for readmissions (odds ratio, 0.25; 95% confidence interval, 0.1-0.62), and average LOS was 17% lower. Increasing age and renal impairment were significantly associated with higher one-year mortality. Greater comorbidity was associated significantly with longer LOS and non-significantly with higher 28-day and one-year mortality. Conclusions: CHF is a common reason for admission, often results in unplanned readmissions, and has a high mortality. Undertreatment with ACE inhibitors continues. The importance of avoiding recurrent admissions was clear. A program of intensive case management may reduce the burden attributable to CHF.

AB - Objectives: To characterise the morbidity, mortality and patterns of care for patients hospitalised with congestive heart failure (CHF). Design: Prospective cohort study with one-year follow-up. Patients: 409 patients aged 60 years and over admitted to hospital with congestive heart failure between 1 May and 30 November 1993. Setting: John Hunter Hospital (tertiary referral for cardiology) and Mater Hospital (non-tertiary referral for cardiology), Newcastle, New South Wales. Outcome measures: Length of hospital stay (LOS); unplanned readmissions; mortality at 28 days and one year; and relationship between outcomes and patient and disease characteristics determined by multivariate analysis. Results: Annual hospitalisation rate for CHF in the 60 years and over age group was 783/100,000, with CHF accounting for 10.9% of patients in this age group. Median LOS was eight days, and varied significantly between hospitals. ACE inhibitors were being taken by 66% of subjects at discharge. Rate of unplanned readmissions within 28 days was 20%. Mortality was 12.5% at 28 days and 33% at one year. For a first admission for CHF, 28-day mortality was lower than for readmissions (odds ratio, 0.25; 95% confidence interval, 0.1-0.62), and average LOS was 17% lower. Increasing age and renal impairment were significantly associated with higher one-year mortality. Greater comorbidity was associated significantly with longer LOS and non-significantly with higher 28-day and one-year mortality. Conclusions: CHF is a common reason for admission, often results in unplanned readmissions, and has a high mortality. Undertreatment with ACE inhibitors continues. The importance of avoiding recurrent admissions was clear. A program of intensive case management may reduce the burden attributable to CHF.

UR - http://www.scopus.com/inward/record.url?scp=0032472896&partnerID=8YFLogxK

M3 - Article

VL - 168

SP - 115

EP - 118

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

IS - 3

ER -

Lowe JM, Candlish PM, Henry DA, Wlodarcyk JH, Heller RF, Fletcher PJ. Management and outcomes of congestive heart failure: A prospective study of hospitalised patients. Medical Journal of Australia. 1998 Feb 2;168(3):115-118.