Precious Time - 'Scientists discover how long heart failure patients can expect to live'



    TORONTO, Feb. 12 /CNW/ - Over 5 million people in North America are
affected. Heart Failure is the leading cause of hospitalization and for the
first time, physicians can now answer the question most patients want to know
- "How long do I have doctor?"
    Published in the February issue of American Heart Journal, the ICES study
identified Ontario patients between 1999 - 2001, who were newly hospitalized
and diagnosed with heart failure. Scientists followed these patients over a
six year period to determine overall prognosis and various high/low risk
patients based on hospital admission characteristics such as: age, blood
pressure, blood tests, prior medical history of stroke, cancer and dementia.
Lead Author and ICES Scientist, Dr. Dennis Ko says, "Heart failure is a very
serious condition with a high recurrence and mortality rate in the elderly
with survival worse than many aggressive cancers. Physicians and patients had
little understanding of prognosis after hospitalization, this information is
crucial to identify patients who may not be suitable for invasive treatment.
There is now an opportunity to begin the engagement of discussion in adapting
a medical plan and exploring an individual's preference. For the first time,
we have a better picture of expected survival in this category of patients and
who may benefit for palliative or end of life care."

    The ICES results:

    
    -  The study sample was restricted to patients who were residents of
       Ontario between 20 and 105 years of age
    -  The average age of heart failure patient was 75.8 years; 50% were
       female
    -  Scientists studied 9,943 patients who were newly hospitalized with
       heart failure over a 2 year period, with a median follow up of
       6 years.
    -  The average survival among hospitalized heart failure patients was
       2.4 years or 29 months.
    -  Survival varied substantially across risk groups: average survival
       was 8 months for patients in high risk group; 3 months in very high
       risk group
    -  Hospitalized heart failure patients had a 1 year mortality of
       33.1% and a 5-year mortality of 68.7%
    

    "An important aspect of heart failure care has not been adequately
addressed", says Dr. Ko. "An end of life conversation does not take place,
mainly because it's difficult for physicians to know which patient has limited
survival. With detailed life expectancy data, we believe our results may
assist in making more informed and difficult treatment decisions focusing on
improving the quality of life among these patients with a few months to live."
    "Heart failure" means that your heart isn't pumping blood as well as it
should. Heart failure doesn't mean your heart has stopped working or that you
are having a heart attack (but, people with heart failure often have had a
heart attack in the past). Heart failure occurs when the heart is unable to
pump sufficient blood to meet the body's demand. It is not a single disease
entity, but rather the end result of a variety of cardiovascular problems.
When heart tissue is damaged and the function of the heart is compromised, the
body initiates compensatory responses such as increased heart rate and
thickening of the heart's muscular wall. The five most common causes of heart
failure are coronary artery disease (due to atherosclerosis), valvular heart
disease, high blood pressure, alcohol, and a disease of heart muscle known as
dilated cardiomyopathy. Each of these five conditions can cause heart failure
by damaging heart muscle and therefore increasing the workload on the
remainder of the heart.

    The study "Life expectancy after an Index Hospitalization for Heart
Failure Patients: A Population Based Study" is in the February issue of
American Heart Journal.

    To view study please visit,
    http://files.newswire.ca/650/ICES_YMHJ_2397.pdf

    Author affiliations: ICES (Drs.Ko, Alter, You, Tu) Mr. Austin, Qiu,
Ms.Stukel); Division of Cardiology,Schulich Heart Centre, Sunnybrook Health
Sciences Centre (Drs. Ko, Tu); Division of Cardiology and the Li Ka Shing
Knowledge Institute of St. Michael's Hospital (Dr.Alter); Division of
Cardiology, University Health Network (Dr.Lee); Center for the Evaluative
Clinical Sciences, Dartmouth Medical School, NH; (Ms.Stukel); Division of
General Internal Medicine, Sunnybrook Health Sciences Centre (Dr.Tu); Toronto,
Ontario.

    ICES is an independent, non-profit organization that uses
population-based health information to produce knowledge on a broad range of
health care issues. Our unbiased evidence provides measures of health system
performance, a clearer understanding of the shifting health care needs of
Ontarians, and a stimulus for discussion of practical solutions to optimize
scarce resources. ICES knowledge is highly regarded in Canada and abroad, and
is widely used by government, hospitals, planners, and practitioners to make
decisions about care delivery and to develop policy.





For further information:

For further information: Kristine Galka, Media Advisor, ICES, (416)
480-4780 or (416) 629-8493, kristine.galka@ices.on.ca

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INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES

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