Survival after an Acute Heart Failure Admission. Twelve-Month Outcomes from the NSW HF Snapshot Study.

Newton, PJ; Si, S; Reid, CM; Davidson, PM; Hayward, CS; Macdonald, PS; NSW HF Snapshot Investigators

Survival after an Acute Heart Failure Admission. Twelve-Month Outcomes from the NSW HF Snapshot Study.

Newton, PJ Si, S Reid, CM Davidson, PM Hayward, CS Macdonald, PS NSW HF Snapshot Investigators

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Heart Lung and Circulation, 2020, 29, (7), pp. 1032-1038
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Newton, PJ
dc.contributor.author	Si, S
dc.contributor.author	Reid, CM
dc.contributor.author	Davidson, PM
dc.contributor.author	Hayward, CS
dc.contributor.author	Macdonald, PS
dc.contributor.author	NSW HF Snapshot Investigators
dc.date.accessioned	2020-09-22T06:14:43Z
dc.date.available	2019-09-02
dc.date.available	2020-09-22T06:14:43Z
dc.date.issued	2020
dc.identifier.citation	Heart Lung and Circulation, 2020, 29, (7), pp. 1032-1038
dc.identifier.issn	1443-9506
dc.identifier.issn	1444-2892
dc.identifier.uri	http://hdl.handle.net/10453/142801
dc.description.abstract	BACKGROUND:The New South Wales (NSW) Heart Failure Snapshot sought to provide a contemporaneous profile of patients admitted with acute heart failure. We have previously reported the baseline results, and this paper reports the 30-day and 12-month outcomes. METHODS:A prospective audit of consecutive patients admitted to 24 teaching hospitals across NSW and the Australian Capital Territory in July-August 2013 with acute heart failure. Follow-up data were obtained by integration of hospital administrative records and follow-up phone calls with the patients. RESULTS:Eight hundred eleven (811) patients were recruited across the 24 sites. The NSW HF Snapshot was an elderly cohort (77 ± 14 yrs) with high comorbidity (mean Charlson Comorbidity Index 3.5 ± 2.6), and 71% were frail at baseline. Twenty-four per cent (24%) of patients were readmitted within 30-days post discharge. One hundred seventy-eight (178) patients died within 12 months post discharge. The independent predictors of death were frailty (Hazard Ratio 1.98 [95% Confidence interval 1.18-3.30]; p < 0.01) Charlson Comorbidity Index (HR 1.06 [95% CI 1.00-1.13]; p = 0.05); New York Heart Association (NYHA) class 4 (HR 2.62 [95% CI 1.32-5.22]; p < 0.01); eGFR<30 ml/min/1.73 m2 (HR 2.16 [95% CI 1.45-3.21]; p < 0.01); hypokalaemia at discharge (HR 2.55 [95% CI 1.44-4.51]; p < 0.01) and readmission within 30 days of baseline admission (HR 2.13 [95% CI 1.49-3.13]; p < 0.01). CONCLUSION:In one of the largest prospective audits of acute heart failure outcomes in Australia, we found that short-term readmissions and mortality at 12 months remain high but were largely driven by patient-level factors.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Heart Lung and Circulation
dc.relation.isbasedon	10.1016/j.hlc.2019.09.004
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1117 Public Health and Health Services
dc.subject.classification	Cardiovascular System & Hematology
dc.title	Survival after an Acute Heart Failure Admission. Twelve-Month Outcomes from the NSW HF Snapshot Study.
dc.type	Journal Article
utslib.citation.volume	29
utslib.location.activity	Australia
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1117 Public Health and Health Services
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2020-09-22T06:14:36Z
pubs.issue	7
pubs.publication-status	Published
pubs.volume	29
utslib.citation.issue	7

Abstract:

BACKGROUND:The New South Wales (NSW) Heart Failure Snapshot sought to provide a contemporaneous profile of patients admitted with acute heart failure. We have previously reported the baseline results, and this paper reports the 30-day and 12-month outcomes. METHODS:A prospective audit of consecutive patients admitted to 24 teaching hospitals across NSW and the Australian Capital Territory in July-August 2013 with acute heart failure. Follow-up data were obtained by integration of hospital administrative records and follow-up phone calls with the patients. RESULTS:Eight hundred eleven (811) patients were recruited across the 24 sites. The NSW HF Snapshot was an elderly cohort (77 ± 14 yrs) with high comorbidity (mean Charlson Comorbidity Index 3.5 ± 2.6), and 71% were frail at baseline. Twenty-four per cent (24%) of patients were readmitted within 30-days post discharge. One hundred seventy-eight (178) patients died within 12 months post discharge. The independent predictors of death were frailty (Hazard Ratio 1.98 [95% Confidence interval 1.18-3.30]; p < 0.01) Charlson Comorbidity Index (HR 1.06 [95% CI 1.00-1.13]; p = 0.05); New York Heart Association (NYHA) class 4 (HR 2.62 [95% CI 1.32-5.22]; p < 0.01); eGFR<30 ml/min/1.73 m2 (HR 2.16 [95% CI 1.45-3.21]; p < 0.01); hypokalaemia at discharge (HR 2.55 [95% CI 1.44-4.51]; p < 0.01) and readmission within 30 days of baseline admission (HR 2.13 [95% CI 1.49-3.13]; p < 0.01). CONCLUSION:In one of the largest prospective audits of acute heart failure outcomes in Australia, we found that short-term readmissions and mortality at 12 months remain high but were largely driven by patient-level factors.

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