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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 263-299 |
| Number of pages | 37 |
| Journal | Journal of Cardiac Failure |
| Volume | 21 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2015 |
| Externally published | Yes |
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Keywords
- AHA Scientific Statements
- exercise
- heart failure
- hospital discharge
- palliative medicine
- rehabilitation
- skilled nursing facility
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Heart failure management in skilled nursing facilities : A scientific statement from the American Heart Association and the Heart Failure Society of America. / Jurgens, Corrine Y.; Goodlin, Sarah; Dolansky, Mary; Ahmed, Ali; Fonarow, Gregg C.; Boxer, Rebecca; Arena, Ross; Blank, Lenore; Buck, Harleah G.; Cranmer, Kerry; Fleg, Jerome L.; Lampert, Rachel J.; Lennie, Terry A.; Lindenfeld, Joann; Piña, Ileana L.; Semla, Todd P.; Trebbien, Patricia; Rich, Michael W.
In: Journal of Cardiac Failure, Vol. 21, No. 4, 01.04.2015, p. 263-299.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heart failure management in skilled nursing facilities
T2 - A scientific statement from the American Heart Association and the Heart Failure Society of America
AU - Jurgens, Corrine Y.
AU - Goodlin, Sarah
AU - Dolansky, Mary
AU - Ahmed, Ali
AU - Fonarow, Gregg C.
AU - Boxer, Rebecca
AU - Arena, Ross
AU - Blank, Lenore
AU - Buck, Harleah G.
AU - Cranmer, Kerry
AU - Fleg, Jerome L.
AU - Lampert, Rachel J.
AU - Lennie, Terry A.
AU - Lindenfeld, Joann
AU - Piña, Ileana L.
AU - Semla, Todd P.
AU - Trebbien, Patricia
AU - Rich, Michael W.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - 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.
AB - 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.
KW - AHA Scientific Statements
KW - exercise
KW - heart failure
KW - hospital discharge
KW - palliative medicine
KW - rehabilitation
KW - skilled nursing facility
UR - http://www.scopus.com/inward/record.url?scp=84926661341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926661341&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2015.02.007
DO - 10.1016/j.cardfail.2015.02.007
M3 - Article
VL - 21
SP - 263
EP - 299
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 4
ER -