One-year follow-up of heart failure patients after their first admission

Outcomes related to heart failure remain relatively poor.

To examine the clinical course of patients for one year after their first admission because of heart failure, including prognosis, mortality, and rehospitalization.

Prospective observational study.

Of 121 patients hospitalized over 6 months for decompensation of previously unknown heart failure, we excluded those with a possible previous diagnosis of heart failure (n = 5), who suffered from another serious disease with a poor prognosis (n = 6), died during the index hospitalization (n = 5), refused to participate (n = 4) or were lost to follow-up (n = 6). Mortality and readmissions were identified by prospective follow-up of all patients.

Of the 98 patients evaluated, half (49) were women. Mean +/- SD age was 75.2 +/- 12 years. The 1-year case-fatality rate after the first admission was 24%; 19% of the deaths were heart failure-related, with progressive pump failure the predominant cause (14% of the total). Age was the only factor associated with increased mortality (p < 0.007). Of the 74 survivors, 32% experienced at least one hospital readmission during follow-up.

The prognosis of unselected new cases of heart failure after their first hospitalization remains relatively poor, despite recent advances in pharmacological therapy and medical care.