Heart failureLong-Term Outcomes of Medicare Beneficiaries With Worsening Renal Function During Hospitalization for Heart Failure
Section snippets
Methods
We accessed clinical data for the study from the OPTIMIZE-HF registry. We also obtained research-identifiable Medicare claims data from the Centers for Medicare and Medicaid Services. The OPTIMIZE-HF registry contains data for patients admitted with HF from January 1, 2003, through December 31, 2004, at 259 participating hospitals.8, 9, 10 Eligible patients were those who presented with symptoms of HF during a hospitalization for which HF was the primary discharge diagnosis or for whom
Results
After we linked OPTIMIZE-HF hospitalizations to Medicare inpatient claims and applied the exclusion criteria, the study population included 20,063 patients hospitalized with HF, of whom 3,581 (17.8%) had worsening RF at discharge. Median age was 80 years, and 56.2% were women. Cause of HF was ischemic in 9,671 patients (48.2%), and 7,246 patients (36.1%) had systolic dysfunction.
Table 1 lists baseline demographic characteristics of patients with worsening RF and those without. Patients with
Discussion
This analysis is the first large study of patients hospitalized with acute HF outside clinical trial settings to show a significant association between worsening RF and 1-year all-cause mortality. Although we found several predictors of long-term mortality, worsening RF remained an independent predictor after adjustment for baseline characteristics and comorbid conditions. Weinfeld et al8 reported an association between worsening RF during HF hospitalization and long-term mortality; however,
Acknowledgment
We thank Damon M. Seils, MA, Duke University, for assistance with preparation of this report. Mr. Seils did not receive compensation for his assistance apart from his employment at the institution where the study was conducted.
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Cited by (0)
This study was funded by an unrestricted educational grant from Merck & Co., Whitehouse Station, New Jersey. The OPTIMIZE-HF registry was funded by GlaxoSmithKline, Research Triangle Park, North Carolina. Dr. Hernandez is supported by American Heart Association Pharmaceutical Roundtable Grant 0675060N. Dr. Fonarow is supported by the Ahmanson Foundation, Beverly Hills, California, and the Corday Family Foundation, Beverly Hills, California.