Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care

Paul J. Hauptman, Sarah Goodlin, Margarita Lopatin, Maria Rosa Costanzo, Gregg C. Fonarow, Clyde W. Yancy

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Hospice is a potential option for patients with end-stage heart failure whose symptoms and clinical status have progressed despite maximal medical therapy. However, little is known about hospice referral practices when patients are admitted because of acute decompensated heart failure. Methods: Data from the Acute Decompensated Heart Failure Registry (ADHERE) were analyzed from October 1, 2001, to December 31, 2005, accounting for 182 898 patient episodes with known disposition from 307 hospitals. Demographic data, clinical characteristics, and medical management were compared in the group discharged to hospice vs patients discharged to home or to intermediate-care facilities. Hospitals, stratified by frequency of discharge of patients to hospice, were evaluated for adherence to performance measures. Temporal trends according to discharge category were analyzed using analysis of variance, and predictors of hospice referral were determined by multivariate analysis. Results: The hospice cohort composed 1.6% (n=3010) of the total sample. Patients referred to hospice were generally older, more likely to have been admitted because of antecedent heart failure in the preceding 6 months, more likely to receive intravenous inotropic therapy, less likely to receive angiotensin-converting enzyme inhibitors, and less likely to undergo a procedure (eg, dialysis or cardiac catheterization) during the hospitalization. The median rate of hospice referral increased from 0.8% in 2001 to 1.3% in 2005 (P

Original languageEnglish (US)
Pages (from-to)1990-1997
Number of pages8
JournalArchives of Internal Medicine
Volume167
Issue number18
DOIs
StatePublished - Oct 8 2007
Externally publishedYes

Fingerprint

Hospice Care
Hospices
Heart Failure
Referral and Consultation
Intermediate Care Facilities
Patient Discharge
Cardiac Catheterization
Angiotensin-Converting Enzyme Inhibitors
Registries
Dialysis
Analysis of Variance
Hospitalization
Multivariate Analysis
Demography
Therapeutics

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care. / Hauptman, Paul J.; Goodlin, Sarah; Lopatin, Margarita; Costanzo, Maria Rosa; Fonarow, Gregg C.; Yancy, Clyde W.

In: Archives of Internal Medicine, Vol. 167, No. 18, 08.10.2007, p. 1990-1997.

Research output: Contribution to journalArticle

Hauptman, Paul J. ; Goodlin, Sarah ; Lopatin, Margarita ; Costanzo, Maria Rosa ; Fonarow, Gregg C. ; Yancy, Clyde W. / Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 18. pp. 1990-1997.
@article{9ce7e4a18a3449faa4e33af3c0cabf2a,
title = "Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care",
abstract = "Background: Hospice is a potential option for patients with end-stage heart failure whose symptoms and clinical status have progressed despite maximal medical therapy. However, little is known about hospice referral practices when patients are admitted because of acute decompensated heart failure. Methods: Data from the Acute Decompensated Heart Failure Registry (ADHERE) were analyzed from October 1, 2001, to December 31, 2005, accounting for 182 898 patient episodes with known disposition from 307 hospitals. Demographic data, clinical characteristics, and medical management were compared in the group discharged to hospice vs patients discharged to home or to intermediate-care facilities. Hospitals, stratified by frequency of discharge of patients to hospice, were evaluated for adherence to performance measures. Temporal trends according to discharge category were analyzed using analysis of variance, and predictors of hospice referral were determined by multivariate analysis. Results: The hospice cohort composed 1.6{\%} (n=3010) of the total sample. Patients referred to hospice were generally older, more likely to have been admitted because of antecedent heart failure in the preceding 6 months, more likely to receive intravenous inotropic therapy, less likely to receive angiotensin-converting enzyme inhibitors, and less likely to undergo a procedure (eg, dialysis or cardiac catheterization) during the hospitalization. The median rate of hospice referral increased from 0.8{\%} in 2001 to 1.3{\%} in 2005 (P",
author = "Hauptman, {Paul J.} and Sarah Goodlin and Margarita Lopatin and Costanzo, {Maria Rosa} and Fonarow, {Gregg C.} and Yancy, {Clyde W.}",
year = "2007",
month = "10",
day = "8",
doi = "10.1001/archinte.167.18.1990",
language = "English (US)",
volume = "167",
pages = "1990--1997",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "18",

}

TY - JOUR

T1 - Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care

AU - Hauptman, Paul J.

AU - Goodlin, Sarah

AU - Lopatin, Margarita

AU - Costanzo, Maria Rosa

AU - Fonarow, Gregg C.

AU - Yancy, Clyde W.

PY - 2007/10/8

Y1 - 2007/10/8

N2 - Background: Hospice is a potential option for patients with end-stage heart failure whose symptoms and clinical status have progressed despite maximal medical therapy. However, little is known about hospice referral practices when patients are admitted because of acute decompensated heart failure. Methods: Data from the Acute Decompensated Heart Failure Registry (ADHERE) were analyzed from October 1, 2001, to December 31, 2005, accounting for 182 898 patient episodes with known disposition from 307 hospitals. Demographic data, clinical characteristics, and medical management were compared in the group discharged to hospice vs patients discharged to home or to intermediate-care facilities. Hospitals, stratified by frequency of discharge of patients to hospice, were evaluated for adherence to performance measures. Temporal trends according to discharge category were analyzed using analysis of variance, and predictors of hospice referral were determined by multivariate analysis. Results: The hospice cohort composed 1.6% (n=3010) of the total sample. Patients referred to hospice were generally older, more likely to have been admitted because of antecedent heart failure in the preceding 6 months, more likely to receive intravenous inotropic therapy, less likely to receive angiotensin-converting enzyme inhibitors, and less likely to undergo a procedure (eg, dialysis or cardiac catheterization) during the hospitalization. The median rate of hospice referral increased from 0.8% in 2001 to 1.3% in 2005 (P

AB - Background: Hospice is a potential option for patients with end-stage heart failure whose symptoms and clinical status have progressed despite maximal medical therapy. However, little is known about hospice referral practices when patients are admitted because of acute decompensated heart failure. Methods: Data from the Acute Decompensated Heart Failure Registry (ADHERE) were analyzed from October 1, 2001, to December 31, 2005, accounting for 182 898 patient episodes with known disposition from 307 hospitals. Demographic data, clinical characteristics, and medical management were compared in the group discharged to hospice vs patients discharged to home or to intermediate-care facilities. Hospitals, stratified by frequency of discharge of patients to hospice, were evaluated for adherence to performance measures. Temporal trends according to discharge category were analyzed using analysis of variance, and predictors of hospice referral were determined by multivariate analysis. Results: The hospice cohort composed 1.6% (n=3010) of the total sample. Patients referred to hospice were generally older, more likely to have been admitted because of antecedent heart failure in the preceding 6 months, more likely to receive intravenous inotropic therapy, less likely to receive angiotensin-converting enzyme inhibitors, and less likely to undergo a procedure (eg, dialysis or cardiac catheterization) during the hospitalization. The median rate of hospice referral increased from 0.8% in 2001 to 1.3% in 2005 (P

UR - http://www.scopus.com/inward/record.url?scp=35348948536&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35348948536&partnerID=8YFLogxK

U2 - 10.1001/archinte.167.18.1990

DO - 10.1001/archinte.167.18.1990

M3 - Article

VL - 167

SP - 1990

EP - 1997

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 18

ER -