HFSA: Knowing hospitalization history can impact long-term mortality
BOSTON—For low-risk patients, mortality increases when the number of prior heart failure (HF) hospitalizations increase, however, long-term mortality impacts differ by baseline risk of death, Scott L. Hummel, MD, of the University of Michigan Health System in Ann Arbor, Mich., said during the rapid fire abstracts session Sept. 19 at the 15th annual Heart Failure Society of America (HFSA) scientific meeting. If HF hospitalization data are acquired, HF resources may be better utilized.
While previous data have shown that knowing about HF hospitalizations could increase HF, it remains unknown whether this impact differs by baseline mortality risk.
During the session, Hummel presented the results of the Mid-Michigan GAP (Guidelines Applied in Practice)-HF study, which tracked HF patients who were admitted to 14 hospitals in Michigan between 2002 and 2004. The study included 2,221 Medicare patients. The researchers grouped prior hospitalizations as: zero, one, two-three and more than four hospitalizations.
Additionally, one-year mortality was estimated with the EFFECT (Enhanced Feedback for Effective Cardiac Treatment) model, which classified patients as low-risk (EFFECT, less than 90), moderate (91 to 120) and high-risk (more than 120).
“As the prior number of heart failure hospitalizations increased, mortality also significantly increased,” Hummel noted.
While Hummel noted that the EFFECT model was able to predict one-year mortality “reasonably well,” he said that prior HF hospitalizations only “modestly improved discrimination across the entire cohort.”
Prior HF hospitalizations had a significant impact on one-year mortality, but this was different by baseline EFFECT scores. For example, while the hazard ratio was 1.33 for low-risk patients, it was 1.22 for high-risk.
“This easily obtained information could help allocate specialized HF resources to the subset of low-risk patients most likely to benefit,” Hummel concluded.
While previous data have shown that knowing about HF hospitalizations could increase HF, it remains unknown whether this impact differs by baseline mortality risk.
During the session, Hummel presented the results of the Mid-Michigan GAP (Guidelines Applied in Practice)-HF study, which tracked HF patients who were admitted to 14 hospitals in Michigan between 2002 and 2004. The study included 2,221 Medicare patients. The researchers grouped prior hospitalizations as: zero, one, two-three and more than four hospitalizations.
Additionally, one-year mortality was estimated with the EFFECT (Enhanced Feedback for Effective Cardiac Treatment) model, which classified patients as low-risk (EFFECT, less than 90), moderate (91 to 120) and high-risk (more than 120).
“As the prior number of heart failure hospitalizations increased, mortality also significantly increased,” Hummel noted.
While Hummel noted that the EFFECT model was able to predict one-year mortality “reasonably well,” he said that prior HF hospitalizations only “modestly improved discrimination across the entire cohort.”
Prior HF hospitalizations had a significant impact on one-year mortality, but this was different by baseline EFFECT scores. For example, while the hazard ratio was 1.33 for low-risk patients, it was 1.22 for high-risk.
“This easily obtained information could help allocate specialized HF resources to the subset of low-risk patients most likely to benefit,” Hummel concluded.