Clinical characteristics of nursing home residents hospitalized with heart failure.
OBJECTIVE
The purpose of this retrospective study was to describe the clinical characteristics of heart failure among nursing home residents hospitalized with heart failure and determine the validity of dyspnea at rest in the diagnosis of heart failure.


METHODS
Subjects were nursing home residents hospitalized with a diagnosis of heart failure. Data on demographic and various admission characteristics were collected by chart abstraction. Proportions of patients presenting with various symptoms and signs of heart failure have been described. The diagnosis of heart failure was confirmed using modified Framingham criteria. The sensitivity, specificity, and positive predictive value of the symptom of dyspnea at rest in the diagnosis of heart failure in nursing home residents hospitalized with heart failure were then estimated.


RESULTS
Patients (N = 98) were elderly, predominantly female and about one-fifth African-American. Dyspnea at rest was the presenting symptom of 85 (87%) patients. Sixty-eight (69%) patients met modified Framingham criteria for the diagnosis of heart failure. Dyspnea at rest had a sensitivity of 91%, specificity of 23%, and predictive value positive of 73% for diagnosis of heart failure.


CONCLUSIONS
Dyspnea at rest was the most common symptom among this cohort of nursing home residents hospitalized with heart failure and has a potential to play a useful role in the diagnosis of heart failure in these patients.
Ahmed
Ali
A
Department of Medicine, School of Medicine, and Center for Aging, University of Alabama at Birmingham, and Heart Failure Clinic and Section of Geriatrics, Veterans Affairs Medical Center, 35294-2041, USA. aahmed@uab.edu