July 2008

Hospitalization linked to increased mortality in heart failure patients

Patients with heart failure are at increased risk of death if hospitalized for worsening heart failure symptoms, according to research from UAB (University of Alabama at Birmingham). The findings, published in the April 2008 Journal of Cardiac Failure, suggest a new emphasis on avoiding the need to hospitalize heart failure patients is required in medicine.

In a study funded by the National Heart, Lung and Blood Institute, Ali Ahmed, MD, MPH -- associate professor in the division of gerontology, geriatrics and palliative care medicine and director of UAB’s Geriatric Heart Failure Clinic -- and colleagues studied 7,788 patients enrolled in the Digitalis Investigation Group, a large clinical trial of heart failure patients conducted in 302 centers in the U.S. and Canada.

The group found that compared to patients who had no hospitalization due to worsening heart failure during two years after randomization, those with heart failure hospitalization had about 150% increase in the risk of subsequent death from all causes (occurring after the first two years). Risk of death due to cardiovascular causes increased by 188%, and due to progressive heart failure, by 422%.

“Clinicians should focus on the prevention of heart failure hospitalization in ambulatory chronic heart failure patients and once a heart failure patient is hospitalized, on improving post-discharge outcomes including re-hospitalization and mortality,” Dr. Ahmed stated. “This could be achieved by the use of evidence-based therapy, patient education, and research to develop new strategies to prevent hospital admission and improve post-discharge outcomes.”