title: Long-term survival for patients with acute decompensated heart failure according to ejection fraction findings.
abstract: Limited data exist about the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to ejection fraction (EF) findings. The primary objective of this population-based observational study was to characterize and compare trends in long-term prognosis after an episode of ADHF across 3 EF strata. Hospital medical records were reviewed for 3,604 residents of the Worcester, Massachusetts, metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, and 2004 and had EF measurements during their index hospitalizations. The average age of this population was 75 years, most were white, and 44% were men. Approximately 49% of the population had heart failure (HF) with preserved EF (EF ≥ 50%), 37% had HF with reduced EF (EF ≤ 40%), and 14% had HF with borderline EF (EF 41% to 49%). Patients with HF with preserved EF experienced higher postdischarge survival rates than patients with either HF with reduced EF or HF with borderline EF at 1, 2, and 5 years after discharge from all central Massachusetts medical centers. Although prognosis at 1 year after hospital discharge improved for all patient groups during the years under study, especially for those with HF with reduced EF and HF with preserved EF, these encouraging trends decreased with increasing duration of follow-up. In conclusion, although improvements in 1-year postdischarge survival were observed for patients in each of the 3 EF groups examined to varying degrees, the postdischarge prognosis of all patients with ADHF remains guarded.
authors.affiliation: Program in Gene Function and Expression, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Coles
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Fisher
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Chad
authors.initials: C
authors.lastname: Darling
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Jorge
authors.initials: J
authors.lastname: Yarzebski
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Darleen
authors.initials: D
authors.lastname: Lessard
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: robert.goldberg@umassmed.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000208:Acute Disease; D000368:Aged; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
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