One-year follow-up of heart failure patients after their first admission

Abstract

Background: Outcomes related to heart failure remain relatively poor. Aim: To examine the clinical course of patients for one year after their first admission because of heart failure, including prognosis, mortality, and rehospitalization. Design: Prospective observational study. Methods: Of 121 patients hospitalized over 6 months for decompensation of previously unknown heart failure, we excluded those with a possible previous diagnosis of heart failure (n=5), who suffered from another serious disease with a poor prognosis (n=6), died during the index hospitalization (n=5), refused to participate (n=4) or were lost to follow-up (n=6). Mortality and readmissions were identified by prospective follow-up of all patients. Results: Of the 98 patients evaluated, half (49) were women. Mean ± SD age was 75.2 ± 12 years. The 1-year case-fatality rate after the first admission was 24%; 19% of the deaths were heart failure-related, with progressive pump failure the predominant cause (14% of the total). Age was the only factor associated with increased mortality (p<0.007). Of the 74 survivors, 32% experienced at least one hospital readmission during follow-up. Discussion: The prognosis of unselected new cases of heart failure after their first hospitalization remains relatively poor, despite recent advances in pharmacological therapy and medical care.