Who are they? Patients with heart failure in American skilled nursing facilities
Department of Quantitative Health Sciences
Cardiology | Cardiovascular Diseases | Geriatrics
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.
Cross-sectional study, Heart failure with preserved ejection fraction, Heart failure with reduced ejection fraction, Skilled nursing facility
DOI of Published Version
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
Journal of cardiology
Li, Lin; Jesdale, William M.; Hume, Anne; Gambassi, Giovanni; Goldberg, Robert J.; and Lapane, Kate L., "Who are they? Patients with heart failure in American skilled nursing facilities" (2017). University of Massachusetts Medical School Faculty Publications. 1410.