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One-year mortality among unselected outpatients with heart failure

J Muntwyler1, G Abetel, C Gruner

  • 1Department of Internal Medicine, Room C-Hor 47, University Hospital, Rämistrasse 100, 8091 Zürich, Switzerland.

European Heart Journal
|November 26, 2002
PubMed

Insights

Heart failure patients in primary care face a 12.6% one-year mortality rate, significantly higher than the general population. Prognostic factors include advanced heart failure stages and recent hospitalizations.

Area of Science:

  • Cardiology
  • Primary Care Medicine
  • Public Health

Background:

  • Heart failure is a growing global health concern.
  • Effective prognosis estimation in primary care is crucial for patient management.
  • Unselected outpatient heart failure populations require further prognostic investigation.

Purpose of the Study:

  • To determine the 1-year mortality rate in unselected heart failure outpatients.
  • To identify key prognostic factors influencing mortality in this cohort.
  • To compare physician-perceived mortality with observed outcomes.

Main Methods:

  • A cohort of 411 heart failure patients (NYHA class II-IV) was recruited from 71 Swiss primary care offices.
  • Follow-up data was collected over a mean period of 1.4 years.
  • Multivariate Cox regression analysis identified significant predictors of mortality.

Main Results:

  • The one-year mortality rate was 12.6%, three times higher than the general Swiss population (SMR 3.0).
  • Mortality increased with NYHA class (II: 7.1%, III: 15.0%, IV: 28.0%).
  • Significant mortality predictors included advanced NYHA class, recent hospitalization, elevated creatinine, low systolic blood pressure, high heart rate, and age. Female gender was associated with lower mortality.

Conclusions:

  • Unselected heart failure outpatients exhibit a poor prognosis, especially those with advanced disease or recent hospital stays.
  • Primary care physicians tend to overestimate mortality, indicating an awareness of the severity in this patient group.
Abstract

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