title: Heart failure in nursing home residents; a cross-sectional study to determine the prevalence and clinical characteristics.
abstract: BACKGROUND
  Heart failure (HF) is expected to be highly prevalent in nursing home residents, but precise figures are scarce. The aim of this study was to determine the prevalence of HF in nursing home residents and to get insight in the clinical characteristics of residents with HF.
  
  
  METHODS
  The study followed a multi-centre cross-sectional design. Nursing home residents (n = 501) in the southern part of the Netherlands aged over 65 years and receiving long-term somatic or psychogeriatric care were included in the study. The diagnosis of HF and related characteristics were based on data collected from actual clinical examinations (including history, physical examination, ECG, cardiac markers and echocardiography), patient records and questionnaires. A panel of two cardiologists and a geriatrician ultimately judged the data to diagnose HF.
  
  
  RESULTS
  The overall prevalence of HF in nursing home residents was 33 %, of which 52 % had HF with preserved ejection fraction. The symptoms dyspnoea and oedema and a cardiac history were more common in residents with HF. Diabetes mellitus, chronic obstructive pulmonary disease (COPD) were also more prevalent in those with HF. Residents with HF had a higher score on the Mini Mental State Examination. 54 % of those with HF where not known before, and in 31 % with a history of HF, this diagnosis was not confirmed by the expert panel.
  
  
  CONCLUSIONS
  This study shows that HF is highly prevalent in nursing home residents with many unknown or falsely diagnosed with HF. Equal number of HF patients had reduced and preserved left-ventricular ejection fraction.
  
  
  BACKGROUND
  The Netherlands National Trial Register NTR2663 (27-12-2010).
authors.affiliation: Department of Health Services Research, Research School Caphri, Maastricht University, Maastricht, The Netherlands. m.vandervelden@maastrichtuniversity.nl.
authors.forename: Mariëlle A M J
authors.initials: MA
authors.lastname: Daamen
authors.affiliation: Department of Health Services Research, Research School Caphri, Maastricht University, Maastricht, The Netherlands. jph.hamers@maastrichtuniversity.nl.
authors.forename: Jan P H
authors.initials: JP
authors.lastname: Hamers
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands. a.gorgels@mumc.nl.
authors.forename: Anton P M
authors.initials: AP
authors.lastname: Gorgels
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands. hp.brunnerlarocca@mumc.nl.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Brunner-La Rocca
authors.affiliation: Department of Methodology and Statistics, Research School Caphri, Maastricht University, Maastricht, The Netherlands. f.tan@maastrichtuniversity.nl.
authors.forename: Frans E S
authors.initials: FE
authors.lastname: Tan
authors.affiliation: Department of Clinical Chemistry, Maastricht University Medical Centre, Maastricht, The Netherlands. mp.van.dieijen.visser@maastrichtuniversity.nl.
authors.forename: Marja P
authors.initials: MP
authors.lastname: van Dieijen-Visser
authors.affiliation: Department of Health Services Research, Research School Caphri, Maastricht University, Maastricht, The Netherlands. jos.schols@maastrichtuniversity.nl.|Department of Family Medicine, Research School Caphri, Maastricht University, Maastricht, The Netherlands. jos.schols@maastrichtuniversity.nl.
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006301:Health Services Needs and Demand; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data; D010808:Physical Examination; D015995:Prevalence; D011795:Surveys and Questionnaires