Association of Readmission Penalty Amount with Subsequent 30-Day Risk Standardized Readmission and Mortality Rates Among Patients Hospitalized with Heart Failure: An Analysis of Get With The Guidelines – Heart Failure Participating Centers

AbstractTo analyze the epidemiology, clinical features and costs of hospitalized patients with gout during the last decade in Spain. Retrospective observational study based on data from the Minimum Basic Data Set (MBDS) from the Spanish National Health Service database. Patients ≥ 18 years with any gout diagnosis at discharge who had been admitted to public or private hospitals between 2005 and 2015 were included. Patients were divided in two periods: p1 (2005–2010) and p2 (2011–2015) to compare the number of hospitalizations, mean costs and mortality rates. Data from 192,037 patients with gout was analyzed. There was an increase in the number of hospitalized patients with gout (p < 0.001). The more frequent comorbidities were diabetes (27.6% of patients), kidney disease (26.6%) and heart failure (19.3%). Liver disease (OR 2.61), dementia (OR 2.13), cerebrovascular diseases (OR 1.57), heart failure (OR 1.41), and kidney disease (OR 1.34) were associated with a higher mortality risk. Women had a lower risk of mortality than men (OR 0.85). General mortality rates in these hospitalized patients progressively increased over the years (p < 0.001). In addition, costs gradually rose, presenting a significant increase in p2 even after adjusting for inflation (p = 0.001). A progressive increase in hospitalizations, mortality rates and cost in hospitalized patients with gout was observed. This harmful trend in a preventable illness highlights the need for change and the search for new healthcare strategies.

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Heart Failure Patients Admitted With Elevated Cardiac Troponin Post Implantable Cardioverter-Defibrillator Firing Carry the Highest Mortality Rates

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.06.206 ◽

2010 ◽

Vol 16 (8) ◽

pp. S60

Author(s):

Emad F. Aziz ◽

Juan Pablo Cordova ◽

Balaji Pratap ◽

Manpreet Singh ◽

David Newman ◽

...

Keyword(s):

Heart Failure ◽

Implantable Cardioverter Defibrillator ◽

Cardiac Troponin ◽

Mortality Rates ◽

Cardioverter Defibrillator ◽

Heart Failure Patients

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“Get with the Guidelines Heart Failure Risk Score” for mortality prediction in patients undergoing MitraClip

Clinical Research in Cardiology ◽

10.1007/s00392-021-01804-3 ◽

2021 ◽

Author(s):

Christos Iliadis ◽

Maximilian Spieker ◽

Refik Kavsur ◽

Clemens Metze ◽

Martin Hellmich ◽

...

Keyword(s):

Heart Failure ◽

Risk Score ◽

Goodness Of Fit ◽

Left Ventricular ◽

Risk Scores ◽

Left Ventricular Ejection ◽

Goodness Of Fit Test ◽

Ventricular Ejection Fraction ◽

Failure Risk ◽

Get With The Guidelines

Abstract Background Reliable risk scores in patients undergoing transcatheter edge-to-edge mitral valve repair (TMVR) are lacking. Heart failure is common in these patients, and risk scores derived from heart failure populations might help stratify TMVR patients. Methods Consecutive patients from three Heart Centers undergoing TMVR were enrolled to investigate the association of the “Get with the Guidelines Heart Failure Risk Score” (comprising the variables systolic blood pressure, urea nitrogen, blood sodium, age, heart rate, race, history of chronic obstructive lung disease) with all-cause mortality. Results Among 815 patients with available data 177 patients died during a median follow-up time of 365 days. Estimated 1-year mortality by quartiles of the score (0–37; 38–42, 43–46 and more than 46 points) was 6%, 10%, 23% and 30%, respectively (p < 0.001), with good concordance between observed and predicted mortality rates (goodness of fit test p = 0.46). Every increase of one score point was associated with a 9% increase in the hazard of mortality (95% CI 1.06–1.11%, p < 0.001). The score was associated with long-term mortality independently of left ventricular ejection fraction, NYHA class and NTproBNP, and was equally predictive in primary and secondary mitral regurgitation. Conclusion The “Get with the Guidelines Heart Failure Risk Score” showed a strong association with mortality in patients undergoing TMVR with additive information beyond traditional risk factors. Given the routinely available variables included in this score, application is easy and broadly possible. Graphic abstract

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Prognostic significance of the get with the guidelines-heart failure (GWTG-HF) risk score in patients undergoing trans-catheter tricuspid valve repair (TTVR)

Heart and Vessels ◽

10.1007/s00380-021-01874-3 ◽

2021 ◽

Author(s):

Refik Kavsur ◽

Hannah Emmi Hupp-Herschel ◽

Atsushi Sugiura ◽

Tetsu Tanaka ◽

Can Öztürk ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Mitral Regurgitation ◽

Risk Stratification ◽

Tricuspid Valve ◽

Risk Score ◽

Left Ventricular Ejection ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Get With The Guidelines

AbstractThe Get-With-The-Guidelines-Heart-Failure (GWTG-HF) score is a risk assessment tool to predict mortality in patients with heart-failure (HF). We aimed to evaluate the GWTG-HF score for risk stratification in HF patients with tricuspid regurgitation undergoing trans-catheter tricuspid valve repair (TTVR). In total, 181 patients who underwent TTVR via edge-to-edge repair (86%) or annuloplasty (14%) were enrolled. Patients were categorized into a low- (≤ 43 points), intermediate- (44–53 points) and high-risk score groups (≥ 54 points). TTVR led to an improvement of TR (p < 0.0001) and NYHA (p < 0.0001). Kaplan–Meier analysis and log-rank test revealed that higher GWTG-HF scores were associated with reduced rates of event-free survival regarding mortality (96% vs 89% vs 73%, respectively, p = 0.001) and hospitalization for heart failure (HHF) (89% vs 86% vs 74%, respectively, p = 0.026). After adjusting for important variables like renal function, left ventricular ejection fraction and mitral regurgitation, the GWTG-HF score remained an independent predictor of the composite endpoint of HHF or mortality (hazard ratio 1.04 per 1-point increase, p = 0.029). Other remaining predictors were renal function and mitral regurgitation. The GWTG-HF score used as a risk stratification tool of mortality and HHF maintains its prognostic value in a HF population with severe TR undergoing TTVR.

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Managing heart failure – home or hospital?

Drug and Therapeutics Bulletin ◽

10.1136/dtb.30.16.61 ◽

1992 ◽

Vol 30 (16) ◽

pp. 61-63

Keyword(s):

Heart Failure ◽

General Practice ◽

General Population ◽

Mortality Rates ◽

The Usa ◽

The Uk

In the USA, heart failure affects about 1% of people in their 50s, rising to 10% of those in their 80s,1 and the figure is probably higher in the UK. The symptoms are distressing, usually relentless, and associated with mortality rates four to eight times greater than those in the general population of the same age.1 This article reviews the treatment of uncomplicated heart failure, concentrating on its management in general practice.

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Abstract P237: Is Ischemia/Reperfusion an Efficient Method for Producing Heart Failure in Rats?

Hypertension ◽

10.1161/hyp.68.suppl_1.p237 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Ana Carolina M Omoto ◽

Fábio N Gava ◽

Mauro de Oliveira ◽

Carlos A Silva ◽

Rubens Fazan ◽

...

Keyword(s):

Heart Failure ◽

Diastolic Pressure ◽

Histopathological Examination ◽

Ischemia Reperfusion ◽

Mitral Annulus ◽

Mortality Rates ◽

Tissue Doppler ◽

Left Ventricular ◽

Coronary Artery Ligation ◽

Artery Ligation

Myocardium infarction (MI) elicited by coronary artery ligation (CAL) is commonly used to induce chronic heart failure (HF) in rats. However, CAL shows high mortality rates. Given that ischemia-reperfusion (IR) may cause the development of HF, this approach may be useful for obtaining a model of HF with low mortality rates. Therefore, it was compared the model of CAL vs. IR in rats, evaluating the mortality and cardiac morphological and functional aspects. The IR consisted of 30 minutes of cardiac ischemia. Wistar rats were assigned into three groups: CAL: n=18; IR: n=7; SHAM (fictitious IR): n=7. After four weeks of CAL, the subjects were evaluated by echocardiography and ventriculography as well. The statistical analysis consisted of ANOVA combined with Tukey’s posthoc test (p<0.05). There were no deaths in the IR and SHAM groups, whereas in the CAL group the mortality rate was 33.33% (6 out of 18). In the CAL group echocardiography showed increased left ventricular (LV) cavity during systole (8.3 ± 1mm) and diastole (10.5 ± 1mm); decreased LV free wall during systole (1.4 ± 0.5 mm); increased left atrium/aorta (2.3 ± 0.4) ratio. These changes were not significant in IR (4.8 ± 0.5mm, 7.6 ± 0.6mm, 2.6 ± 0.3 mm, 1.6 ± 0.2) and SHAM (4.6 ± 0.6 mm, 7.7 ± 0.8mm, 2.8 ± 0.4mm, 1.5 ± 0.2) groups. There was also the reduction in the ejection fraction in the CAL group (41 ± 12 %) when compared with IR (65 ± 9%) and SHAM (69 ± 7%) groups. The tissue Doppler analysis from the lateral mitral annulus showed reduction in E′ in CAL (-29 ± 8 mm/s) and IR (-31± 9 mm/s) groups when compared with the SHAM (-48 ± 11 mm/s) group. The ventriculography in the CAL group showed smaller maximum dP/dt (6519 ± 1062) and greater end-diastolic pressure (33 ± 8 mmHg) when compared with IR (8716 ± 756 mmHg/s; 9 ± 9 mmHg) and SHAM (7989 ± 1230 mmHg/s; 9 ± 7 mmHg) groups. The CAL group presented transmural infarct size of 40% of the left ventricular wall, measured under histopathological examination. In conclusion, IR for 30 minutes caused only small changes in LV diastolic function, assessed by tissue Doppler; however, the IR was not effective for promoting HF, as observed with CAL. Thus, it is possible that prolonged IR is necessary for promoting significant HF in rats.

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Development of the Mexican Heart Team: The Long and Winding Road

Cardiology ◽

10.1159/000446472 ◽

2016 ◽

Vol 135 (1) ◽

pp. 53-55

Author(s):

J. Alfredo Merino-Rajme ◽

Lilian G. Delgado-Espejel ◽

Julieta D. Morales-Portano ◽

Marco A. Alcántara-Meléndez ◽

J. Francisco García-García ◽

...

Keyword(s):

Heart Failure ◽

Developing Country ◽

Cause Of Death ◽

Optimal Strategy ◽

Multidisciplinary Approach ◽

Mortality Rates ◽

Heart Team ◽

Current Article

Heart failure (HF) is the leading cause of death worldwide. Efforts to decrease HF mortality rates include a multidisciplinary approach management. Although evidence suggests that this has been an optimal strategy for treating HF, the model remains not widely implanted. The current article explores the rationale behind the formation of a Heart Team in a developing country and its development despite the lack of an allocated budget.

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TEMPORAL TRENDS IN EARLY FOLLOW-UP AFTER HOSPITALIZATION FOR HEART FAILURE: DATA FROM GET WITH THE GUIDELINES-HEART FAILURE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(14)60745-2 ◽

2014 ◽

Vol 63 (12) ◽

pp. A745

Author(s):

Adam DeVore ◽

Margueritte Cox ◽

Zubin Eapen ◽

Clyde Yancy ◽

Deepak Bhatt ◽

...

Keyword(s):

Heart Failure ◽

Temporal Trends ◽

Failure Data ◽

Get With The Guidelines

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Epidemiology of Major Lower Extremity Amputations in Individuals With Diabetes in Austria, 2014-2017: A Retrospective Analysis of Health Insurance Database

10.21203/rs.3.rs-36835/v1 ◽

2020 ◽

Author(s):

Faisal Aziz ◽

Berthold Reichardt ◽

Caren Sourij ◽

Hans-Peter Dimai ◽

Daniela Reichart ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Health Insurance ◽

Lower Extremity ◽

Renal Disease ◽

Mortality Rates ◽

Short And Long Term ◽

Male Sex ◽

Long Term Mortality

Abstract Background: Previous data show a high incidence of major lower extremity amputations (LEA) in Austria. Moreover, recent data on the epidemiology of major LEA are sparse in the Country. This study estimated the incidence and mortality rates of major LEA and assessed risk factors of post major LEA mortality in individuals with diabetes.Methods: A retrospective cohort analysis of 507,180 individuals with diabetes enrolled in the Austrian Health Insurance between 2014 and 2017 was performed. Crude and age-standardized rates of major LEA (hip, femur, knee, lower leg) were estimated by extracting their procedure codes from the database. Short- (30-day, 90-day) and long-term (1-year, 5-year) all-cause cumulative mortality after major LEA was estimated from the date of amputation till the date of death. Poisson regression was performed to compare rates by characteristics and assess the annual trend. The Cox-regression was performed to identify significant risk factors of all-cause mortality after major LEA.Results: A total of 2,165 individuals with diabetes underwent major LEA between 2014 and 2017. The mean age was amputees was 73.0 ±11.3 years, 62.7% were males, and 87.3% had a peripheral vascular disease (PVD). The overall age-standardized rate was 6.44 per 100,000 population. The rate increased with age (p<0.001) and was higher (p<0.001) in males (9.38) than females (5.66). The rate was 5.71 in 2014, 6.86 in 2015, 6.71 in 2016, and 6.66 in 2017, with an insignificant annual change of 3% (p=0.825). The cumulative 30-day mortality was 13.5%, 90-day was 22.0%, 1-year was 34.4%, and 5-year was 66.7%. Age, male sex, above-knee amputation, Charlson index, and heart failure were significantly associated with both short- and long-term mortality. Cancer, dementia, heart failure, PVD, and renal disease were only associated with long-term mortality.Conclusions: The rate of major LEA remained stable between 2014 and 2017 in Austria. Short and long-term mortality rates were considerably high after major LEA. Old age, male sex, above-knee amputations, heart failure, and Charlson Index were significant predictors of both short- and long-term mortality, whereas, comorbidities such as cancer, dementia, PVD, and renal disease were significant predictors of long-term mortality only.

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