@article{a66ceaafd8b94a30a6bf68c01a7eb407,
title = "Heart failure management in skilled nursing facilities: A scientific statement from the American Heart Association and the Heart Failure Society of America",
abstract = "Heart failure (HF) is a complex syndrome in which structural or functional cardiac abnormalities impair the filling of ventricles or left ventricular ejection of blood. HF disproportionately occurs in those ≥65 years of age. 1 Among the estimated 1.5 to 2 million residents in skilled nursing facilities (SNFs) in the United States, cardiovascular disease is the largest diagnostic category, and HF is common. 2,3 Despite the high prevalence of HF in SNF residents, none of the large randomized clinical trials of HF therapy included SNF residents, and very few included patients >80 years of age with complex comorbidities. Several issues make it important to address HF care in SNFs. The healthcare environment and characteristics of SNF residents are distinct from those of communitydwelling adults. Comorbid illness unrelated to HF (eg, dementia, hip fracture) increases with age >75 years, and these conditions may complicate both the initial HF diagnosis and ongoing management. 4-6 Morbidity and mortality rates are significantly increased for hospitalized older adults with HF discharged to SNFs compared with those discharged to other sites. 7Transitions between hospitals and SNFs may be problematic. 8 SNF 30-day rehospitalization rates for HF range from 27% to 43%, 7,9,10 and long-term care residents sent to the emergency department are at increased risk for hospital admission and death. 11 The purpose of this scientific statement is to provide guidance for management of HF in SNFs to improve patient-centered outcomes and reduce hospitalizations. This statement addresses unique issues of SNF care and adapts HF guidelines and other recommendations to this setting.",
keywords = "AHA Scientific Statements, exercise, heart failure, hospital discharge, palliative medicine, rehabilitation, skilled nursing facility",
author = "Jurgens, {Corrine Y.} and Sarah Goodlin and Mary Dolansky and Ali Ahmed and Fonarow, {Gregg C.} and Rebecca Boxer and Ross Arena and Lenore Blank and Buck, {Harleah G.} and Kerry Cranmer and Fleg, {Jerome L.} and Lampert, {Rachel J.} and Lennie, {Terry A.} and Joann Lindenfeld and Pi{\~n}a, {Ileana L.} and Semla, {Todd P.} and Patricia Trebbien and Rich, {Michael W.}",
note = "Funding Information: Writing Group Disclosures Writing Group Member Employment Research Grant Other Research Support Speakers' Bureau/Honoraria Expert Witness Ownership Interest Consultant/Advisory Board Other Corrine Y. Jurgens Stony Brook University None None None None None None None Mary Dolansky Case Western Reserve University None None None None None None None Sara Goodlin VA Medical Center Medtronic ∗ None None None None None None Ali Ahmed Washington DC VA Medical Center None None None None None None None Ross Arena University of Illinois at Chicago None None None None None None None Lenore Blank St. Jude Medical None None None None None Promptcare Home Infusion Co., Clark, NJ* None Rebecca Boxer University of Colorado School of Medicine National Heart, Lung, and Blood Institute † ; NIH † McGregor Foundation † None None None Jennings Center for Older Adults* None Harleah G. Buck Pennsylvania State University None None None None None None None Kerry Cranmer Geriatric Medical Services None None Amgen ∗ ; Eli Lilly † ; Esai ∗ ; Purdue Pharma † None None None None Jerome L. Fleg NHLBI/NIH None None None None None None None Gregg C. Fonarow UCLA None None None None None Amgen ∗ ; Bayer ∗ ; Gambro ∗ ; Janssen ∗ ; Medtronic ∗ ; Novartis † None Rachel J. Lampert Yale School of Medicine Boston Scientific † ; GE Medical † ; Medtronic † ; St. Jude Medical † None Boston Scientific ∗ ; Medtronic ∗ None None None None Terry A. Lennie University of Kentucky National Institute of Nursing Research † None None None None None None JoAnn Lindenfeld University of Colorado Medtronic † ; Zensun ∗ None None None None Medtronic ∗ None Ileana L. Pi{\~n}a Albert Einstein College of Medicine NIH ∗ None GE ∗ None None FDA ∗ ; Novartis ∗ ; ZS Pharmaceuticals ∗ None Michael W. Rich Washington University School of Medicine Astellas Pharmaceuticals ∗ None Sanofi-Aventis ∗ None None None None Todd P. Semla US Department of Veteran Affairs None None American Geriatrics Society ∗ None None AARP ∗ ; Lexi-Comp, Inc. † ; Omnicare, Inc. ∗ Wife is an employee of AbbVie † Patricia Trebbien Alegent Health None None None None None None None ",
year = "2015",
month = apr,
day = "1",
doi = "10.1016/j.cardfail.2015.02.007",
language = "English (US)",
volume = "21",
pages = "263--299",
journal = "Journal of Cardiac Failure",
issn = "1071-9164",
publisher = "Churchill Livingstone",
number = "4",
}