Clinical InvestigationCongestive Heart FailureLife expectancy after an index hospitalization for patients with heart failure: A population-based study☆,☆☆
Section snippets
The EFFECT project
The EFFECT project is an ongoing initiative to improve the quality of care of patients with cardiovascular disease in Ontario, Canada, and has been described in detail elsewhere.16, 17 Briefly, patients admitted to acute care hospitals with a primary diagnosis of HF from April 1999 to March 2001 were identified in the Canadian Institute for Health Information hospital discharge abstract database using the International Classification of Diseases, Ninth Revision, Clinical Modification code 428.
Characteristics of patients with HF in EFFECT
Baseline characteristics and medication use at hospital discharge are shown in Table I. Our study sample included 9943 hospitalized patients with HF followed for a median of 6 years. The mean age of the overall cohort was 75.8 years and 50.4% of the patients were female (Table I). The area under the receiver operating characteristic curve for the EFFECT HF risk score was 0.76 for 30-day mortality, 0.74 for 1-year mortality, and 0.77 for 5-year mortality, indicating good discriminative ability
Discussion
Many patients with HF in clinical practice are elderly with multiple comorbidities and therefore also face many competing risks of death. In an attempt to provide a better understanding of prognosis and to assist in treatment decisions, we examined the life expectancy of patients after their index hospitalization for HF. We found the life expectancy of patients with HF after hospitalization to be much shorter than that of the general population. For instance, we estimated the median life
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Cited by (0)
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The EFFECT study was supported by a grant issued to the Canadian Cardiovascular Outcomes Research Team (CCORT) from the Canadian Institutes of Health Research and the Heart and Stroke Foundation. Dr Ko is supported by a clinician scientist award from the Heart and Stroke Foundation of Ontario. Dr Alter is supported by a career investigator award from the Heart and Stroke Foundation of Ontario. Dr Lee is supported by a clinician scientist award from the Canadian Institutes of Health Research. Dr Tu is supported by a Canadian Research Chair in Health Service Research and a Career Investigator Award from the Heart and Stroke Foundation of Ontario.
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Role of the sponsors: The results and conclusions of this study are those of the authors and should not be attributed to any of the sponsoring agencies.