Prognostic impact of previous hospitalization in acute heart failure patients

West Tokyo Heart Failure Registry Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The natural course of heart failure (HF) is typically associated with repeated hospitalizations, and subsequently, patient prognosis deteriorates. However, the precise relationship between repeated admissions for HF and long-term prognosis remains unknown. Methods and Results: We analyzed data from 1,730 consecutive acute HF patients registered in the West Tokyo Heart Failure (WET-HF) registry between June 2005 and April 2014 (median age, 76 years). Patients were divided into 3 groups according to the number of previous HF admissions at the time of the index admission (0, n=876 [55.4%]; 1, n=425 [26.9%]; ≥2, n=279 [17.7%] previous admissions). A history of multiple previous admissions was an independent predictor for all-cause death and HF readmission in reference to a history of a single previous admission (hazard ratio (HR), 1.53; 95% confidence interval (CI) 1.10–2.13; HR, 1.90 95% CI, 1.47–2.44, respectively) or no previous admissions (HR, 1.37, 95% CI, 1.01–1.85; HR, 2.83, 95% CI, 2.19–3.65, respec-tively). On the other hand, a history of a single previous admission was an independent predictor for HF readmission in reference to a history of no previous admissions (HR, 1.51, 95% CI, 1.18–1.92), but not for all-cause death (HR, 0.89, 95% CI, 0.66–1.20). Conclusions: Based on a contemporary multicenter HF registry, a history of multiple previous HF admissions was revealed as an independent, strong risk factor of adverse events following the index admission. The number of hospitalizations could be a simple and important surrogate indicating subsequent adverse events in patients with HF.

Original languageEnglish
Pages (from-to)1261-1268
Number of pages8
JournalCirculation Journal
Volume83
Issue number6
DOIs
Publication statusPublished - 2019 Jan 1

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Hospitalization
Heart Failure
Confidence Intervals
Registries
Cause of Death
Tokyo

Keywords

  • Heart failure
  • Hospitalization
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic impact of previous hospitalization in acute heart failure patients. / West Tokyo Heart Failure Registry Investigators.

In: Circulation Journal, Vol. 83, No. 6, 01.01.2019, p. 1261-1268.

Research output: Contribution to journalArticle

West Tokyo Heart Failure Registry Investigators 2019, 'Prognostic impact of previous hospitalization in acute heart failure patients', Circulation Journal, vol. 83, no. 6, pp. 1261-1268. https://doi.org/10.1253/circj.CJ-18-1087
West Tokyo Heart Failure Registry Investigators. / Prognostic impact of previous hospitalization in acute heart failure patients. In: Circulation Journal. 2019 ; Vol. 83, No. 6. pp. 1261-1268.
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title = "Prognostic impact of previous hospitalization in acute heart failure patients",
abstract = "Background: The natural course of heart failure (HF) is typically associated with repeated hospitalizations, and subsequently, patient prognosis deteriorates. However, the precise relationship between repeated admissions for HF and long-term prognosis remains unknown. Methods and Results: We analyzed data from 1,730 consecutive acute HF patients registered in the West Tokyo Heart Failure (WET-HF) registry between June 2005 and April 2014 (median age, 76 years). Patients were divided into 3 groups according to the number of previous HF admissions at the time of the index admission (0, n=876 [55.4{\%}]; 1, n=425 [26.9{\%}]; ≥2, n=279 [17.7{\%}] previous admissions). A history of multiple previous admissions was an independent predictor for all-cause death and HF readmission in reference to a history of a single previous admission (hazard ratio (HR), 1.53; 95{\%} confidence interval (CI) 1.10–2.13; HR, 1.90 95{\%} CI, 1.47–2.44, respectively) or no previous admissions (HR, 1.37, 95{\%} CI, 1.01–1.85; HR, 2.83, 95{\%} CI, 2.19–3.65, respec-tively). On the other hand, a history of a single previous admission was an independent predictor for HF readmission in reference to a history of no previous admissions (HR, 1.51, 95{\%} CI, 1.18–1.92), but not for all-cause death (HR, 0.89, 95{\%} CI, 0.66–1.20). Conclusions: Based on a contemporary multicenter HF registry, a history of multiple previous HF admissions was revealed as an independent, strong risk factor of adverse events following the index admission. The number of hospitalizations could be a simple and important surrogate indicating subsequent adverse events in patients with HF.",
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author = "{West Tokyo Heart Failure Registry Investigators} and Keitaro Akita and Takashi Kohno and Shun Kohsaka and Yasuyuki Shiraishi and Yuji Nagatomo and Ayumi Goda and Atsushi Mizuno and Yasumori Sujino and Keiichi Fukuda and Tsutomu Yoshikawa",
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AU - West Tokyo Heart Failure Registry Investigators

AU - Akita, Keitaro

AU - Kohno, Takashi

AU - Kohsaka, Shun

AU - Shiraishi, Yasuyuki

AU - Nagatomo, Yuji

AU - Goda, Ayumi

AU - Mizuno, Atsushi

AU - Sujino, Yasumori

AU - Fukuda, Keiichi

AU - Yoshikawa, Tsutomu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The natural course of heart failure (HF) is typically associated with repeated hospitalizations, and subsequently, patient prognosis deteriorates. However, the precise relationship between repeated admissions for HF and long-term prognosis remains unknown. Methods and Results: We analyzed data from 1,730 consecutive acute HF patients registered in the West Tokyo Heart Failure (WET-HF) registry between June 2005 and April 2014 (median age, 76 years). Patients were divided into 3 groups according to the number of previous HF admissions at the time of the index admission (0, n=876 [55.4%]; 1, n=425 [26.9%]; ≥2, n=279 [17.7%] previous admissions). A history of multiple previous admissions was an independent predictor for all-cause death and HF readmission in reference to a history of a single previous admission (hazard ratio (HR), 1.53; 95% confidence interval (CI) 1.10–2.13; HR, 1.90 95% CI, 1.47–2.44, respectively) or no previous admissions (HR, 1.37, 95% CI, 1.01–1.85; HR, 2.83, 95% CI, 2.19–3.65, respec-tively). On the other hand, a history of a single previous admission was an independent predictor for HF readmission in reference to a history of no previous admissions (HR, 1.51, 95% CI, 1.18–1.92), but not for all-cause death (HR, 0.89, 95% CI, 0.66–1.20). Conclusions: Based on a contemporary multicenter HF registry, a history of multiple previous HF admissions was revealed as an independent, strong risk factor of adverse events following the index admission. The number of hospitalizations could be a simple and important surrogate indicating subsequent adverse events in patients with HF.

AB - Background: The natural course of heart failure (HF) is typically associated with repeated hospitalizations, and subsequently, patient prognosis deteriorates. However, the precise relationship between repeated admissions for HF and long-term prognosis remains unknown. Methods and Results: We analyzed data from 1,730 consecutive acute HF patients registered in the West Tokyo Heart Failure (WET-HF) registry between June 2005 and April 2014 (median age, 76 years). Patients were divided into 3 groups according to the number of previous HF admissions at the time of the index admission (0, n=876 [55.4%]; 1, n=425 [26.9%]; ≥2, n=279 [17.7%] previous admissions). A history of multiple previous admissions was an independent predictor for all-cause death and HF readmission in reference to a history of a single previous admission (hazard ratio (HR), 1.53; 95% confidence interval (CI) 1.10–2.13; HR, 1.90 95% CI, 1.47–2.44, respectively) or no previous admissions (HR, 1.37, 95% CI, 1.01–1.85; HR, 2.83, 95% CI, 2.19–3.65, respec-tively). On the other hand, a history of a single previous admission was an independent predictor for HF readmission in reference to a history of no previous admissions (HR, 1.51, 95% CI, 1.18–1.92), but not for all-cause death (HR, 0.89, 95% CI, 0.66–1.20). Conclusions: Based on a contemporary multicenter HF registry, a history of multiple previous HF admissions was revealed as an independent, strong risk factor of adverse events following the index admission. The number of hospitalizations could be a simple and important surrogate indicating subsequent adverse events in patients with HF.

KW - Heart failure

KW - Hospitalization

KW - Prognosis

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