title: Outcome of Patients Discharged From a Heart Failure Disease Management Program following Their Clinical and Echocardiographic Recovery.
abstract: OBJECTIVE
  Heart failure (HF) is associated with high mortality and frequent hospitalizations. Disease management programs (DMPs) have a favorable impact on patients with HF. No data exist regarding the outcomes of patients discharged from such a program.
  
  
  METHODS
  We examined the outcome of patients with severe systolic HF who were discharged from a DMP following full clinical and echocardiographic recovery. Data were reviewed for mortality, emergency room visits, hospitalizations, medication adherence and left ventricular ejection fraction (EF).
  
  
  RESULTS
  At enrollment and discharge, the mean EF was 19 and 53%, respectively. At follow-up 46.2 months after discharge, 56% of patients had been to the emergency room, 34% were hospitalized a total of 41 times and 20% had died. In the patients who required hospitalization for HF, the mean EF upon rehospitalization had dropped to 23.4%.
  
  
  CONCLUSIONS
  Many patients with initially severe systolic HF who had an almost full recovery in a multidisciplinary DMP had very poor outcomes once they were discharged from the program. It may be appropriate to revisit the practice of discharging patients from DMPs once they have reached a specific clinical target.
authors.affiliation: Department of Internal Medicine, Carolinas Medical Center, Charlotte, N.C., USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Proctor
authors.forename: David Ryan
authors.initials: DR
authors.lastname: King
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Fesel
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Narveson
authors.forename: William E
authors.initials: WE
authors.lastname: Anderson
authors.forename: Laszlo
authors.initials: L
authors.lastname: Littmann
mesh_terms: D000368:Aged; D019468:Disease Management; D004452:Echocardiography; D005260:Female; D054143:Heart Failure, Systolic / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D020127:Recovery of Function; D016896:Treatment Outcome; D016277:Ventricular Function, Left