University of Massachusetts Medical School Faculty Publications

Title

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

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

10-27-2017

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

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