PMID- 12445535
OWN - NLM
STAT- MEDLINE
DCOM- 20030402
LR  - 20190513
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 23
IP  - 23
DP  - 2002 Dec
TI  - One-year mortality among unselected outpatients with heart failure.
PG  - 1861-6
AB  - OBJECTIVE: To estimate 1-year mortality and prognostic factors in unselected 
      outpatients with heart failure, and to compare the observed mortality with the 
      estimates of the primary care physicians. METHODS AND RESULTS: Four hundred and 
      eleven consecutive patients with heart failure New York Heart Association (NYHA) 
      class II-IV (mean population age 75 years, 56% males) were enrolled in 71 primary 
      care offices throughout Switzerland. During a mean follow-up period of 1.4 years, 
      68 patients had died. One-year total mortality was 12.6% compared to 4.3% in the 
      underlying Swiss population (standardized mortality ratio 3.0). Among patients 
      with heart failure NYHA II, III and IV, mortality was 7.1%, 15.0% and 28.0%, 
      respectively. In multivariate Cox regression, statistically significant (P<0.05) 
      predictors of mortality were NYHA class (NYHA III: risk ratio [RR]=1.6; NYHA IV: 
      RR=2.2), recent hospital stay for heart disease (RR=2.3), creatinine>120 
      micromol.l(-1) (RR=1.8) systolic blood pressure<100 mmHg (RR=2.4), heart rate>100 
      min(-1) (RR=2.7), age (per 10 years, RR=1.6) and female gender (RR=0.49). Among 
      patients with reduced left ventricular ejection fraction, 1-year mortality was 
      14.3%, and predictors were similar except that female gender was no longer 
      associated with reduced mortality. Primary care physicians significantly 
      overestimated 1-year mortality (estimated mortality 25.9% vs observed mortality 
      12.6%,P =0.001). CONCLUSIONS: Unselected outpatients with heart failure have a 
      poor prognosis, particularly those with advanced heart failure and a recent 
      hospital stay for heart disease. Primary care physicians are aware of the high 
      mortality of this growing patient population.
CI  - Copyright 2002 The European Society of Cardiology. Published by Elsevier Science 
      Ltd. All rights reserved
FAU - Muntwyler, J
AU  - Muntwyler J
AD  - Department of Internal Medicine, Room C-Hor 47, University Hospital, Ramistrasse 
      100, 8091 Zurich, Switzerland.
FAU - Abetel, G
AU  - Abetel G
FAU - Gruner, C
AU  - Gruner C
FAU - Follath, F
AU  - Follath F
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2002 Dec;23(23):1804-6. PMID: 12445530
MH  - Aged
MH  - Ambulatory Care
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*mortality
MH  - Humans
MH  - Male
MH  - Multivariate Analysis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Switzerland/epidemiology
EDAT- 2002/11/26 04:00
MHDA- 2003/04/04 05:00
CRDT- 2002/11/26 04:00
PHST- 2002/11/26 04:00 [pubmed]
PHST- 2003/04/04 05:00 [medline]
PHST- 2002/11/26 04:00 [entrez]
AID - S0195668X02932823 [pii]
AID - 10.1053/euhj.2002.3282 [doi]
PST - ppublish
SO  - Eur Heart J. 2002 Dec;23(23):1861-6. doi: 10.1053/euhj.2002.3282.