Title

Who are they? Patients with heart failure in American skilled nursing facilities

Authors

Lin Li, University of Massachusetts Medical School
William M. Jesdale, University of Massachusetts Medical SchoolFollow
Anne Hume, University of Rhode Island
Giovanni Gambassi, Catholic University of Sacred Heart
Robert J. Goldberg, University of Massachusetts Medical SchoolFollow
Kate L. Lapane, University of Massachusetts Medical SchoolFollow

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

2017-10-27

Document Type

Article

Disciplines

Cardiology | Cardiovascular Diseases | Geriatrics

Abstract

BACKGROUND: Heart failure (HF) is common among skilled nursing facility (SNF) residents, yet patients with HF in the SNF setting have not been well described.

METHODS: Using Minimum Data Set 3.0 cross-linked to Medicare data (2011-2012), we studied 150,959 HF patients admitted to 13,858 SNFs throughout the USA. ICD-9 codes were used to differentiate patients with HF with preserved ejection fraction (HFpEF), reduced ejection fraction (HFrEF), or unspecified HF.

RESULTS: The median age of the study population was 82 years, 68% were women, 34% had HFpEF, and 27% had HFrEF. HFpEF patients were older than those with HFrEF. Moderate/severe physical limitations (82%) and cognitive impairment (37%) were common, regardless of HF type. The burden and pattern of common comorbidities, with the exception of coronary heart disease, were similar among all groups, with a median of five comorbidities. One half of patients with HF had been prescribed angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and 39% evidence-based beta-blockers.

CONCLUSIONS: SNF residents with HF are old and suffer from significant physical limitations and cognitive impairment and a high degree of comorbidity. These patients differ substantially from HF patients enrolled in randomized clinical trials and that might explain divergence from treatment guidelines.

Keywords

Cross-sectional study, Heart failure with preserved ejection fraction, Heart failure with reduced ejection fraction, Skilled nursing facility

DOI of Published Version

10.1016/j.jjcc.2017.09.008

Source

J Cardiol. 2017 Oct 27. pii: S0914-5087(17)30254-X. doi: 10.1016/j.jjcc.2017.09.008. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Journal of cardiology

PubMed ID

29111304

Repository Citation

Li L, Jesdale WM, Hume A, Gambassi G, Goldberg RJ, Lapane KL. (2017). Who are they? Patients with heart failure in American skilled nursing facilities. UMass Chan Medical School Faculty Publications. https://doi.org/10.1016/j.jjcc.2017.09.008. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/1410