A majority of heart failure (HF) related mortality occurred in patients who opted for a do not resuscitate (DNR) status with end-stage HF, thus limiting the appropriateness of administering evidence-based therapies. This according to a recent study that evaluated the Centers for Medicare and Medicaid Services’ (CMS) 30-day risk-adjusted mortality model and concluded that it fails to take important variables into consideration as an appropriate metric for quality. Electronic records were searched for patients with a diagnosis of HF who died from any cause during hospitalization or within 30-days of admission at a single institution. Researchers found:
- There were 646 HF-related admissions among 530 patients (1.2 admissions/patient).
- 67 of 530 (13%) patients died: 35 (52%) during hospitalization and 32 (48%) after discharge but within 30 days of admission.
- 51 (76%) patients died from HF and 16 (24%) from other causes.
- 55 (82%) patients were classified as AHA Stage-D, 58 (87%) as NYHA Class-IV, and 30 (45%) had right-ventricular systolic dysfunction.
- 57(85%) patients had a DNR status.
- No care gaps were identified that contributed to mortality.
Faillace RT, Yost GW, Chugh Y, et al. Is 30-day mortality after admission for heart failure an appropriate metric for quality? [Published online ahead of print September 20, 2017]. Am J Med. doi:10.1016/j.amjmed.2017.09.007.
This Week's Must Reads
Pharmacologic Tx of Seasonal Allergic Rhinitis, Ann Intern Med; ePub 2017 Nov 28; Wallace, et al
Risk of Obesity From Childhood into Adulthood, N Engl J Med; 2017 Nov 30; Ward, Long, et al
Labeling of Selective Androgen Receptor Modulators, JAMA; 2017 Nov 28; Van Wagoner, Eichner, et al
Oral Capsule vs Colonoscopy FMT for CDI, JAMA; 2017 Nov 28; Kao, Roach, et al
HIV Testing & Impact of Delayed Diagnosis, MMWR; 2017 Dec 1; Dailey, Hoots, et al
Must Reads in Cardiology
Racial/Ethnic Disparities in Hospitalization for HF, J Am Heart Assoc; ePub 2017 Nov 16; Dupre, et al
Hospital Readmissions Following HF Hospitalization, JAMA Cardiol; ePub 2017 Nov 12; Gupta, et al
Clinical Predictive Models for Patients with HF, J Am Heart Assoc; ePub 2017 Nov 18; Wessler, et al
Impact of Diabetes Mellitus After LVAD Implantation, Circ Heart Fail; ePub 2017 Nov 15; Asleh, et al
Epidemiology of HF in Older Adults Across Settings , Circ Heart Fail; ePub 2017 Nov 12; Khera, et al