OUTCOMES OF ACUTE EXACERBATION OF SEVERE CONGESTIVE-HEART-FAILURE - QUALITY-OF-LIFE, RESOURCE USE, AND SURVIVAL

Background: Congestive heart failure (CHF) is a common disease with hi gh health care costs and high mortality rates. Knowledge of the health -related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this population. Methods: A prospective cohort study was conducted involving 1390 adult patients h ospitalized with an acute exacerbation of severe CHF (New York Heart A ssociation class III-IV). Demographic data and health-related quality of life were determined by interview; physiologic status and cost and intensity of care were determined from hospital charts. Results: The m edian (25th, 75th percentiles) age of patients was 68.0 (58.2, 76.9) y ears; 61.7% were male. Survival was 93.40%, at discharge from the inde x hospitalization, 72.9% at 180 days, and 61.5% at 1 year. Of patients interviewed at 180 days, the median health rating on a scale of 0 to 100 (0 indicates death; 100, excellent health) was 60 (interquartile r ange, 50-80), and 59.7% were independent in their activities of daily living. Overall quality of life was reported to be good, very good, or excellent in 58.2% at 180 days. Patients with worse functional capaci ty were more likely to die. Health perceptions among the patients with available interview data improved at 60 and 180 days after acute exac erbation of severe CHF. Conclusions: Patients hospitalized for acute e xacerbation of severe CHF have a generally poor 6-month survival, but survivors retain relatively good functional status and have good healt h perceptions. Furthermore, health perceptions improve after the acute exacerbation.