Impact of atrial fibrillation on mortality and readmission in older adults hospitalized with heart failure.

Background: Atrial fibrillation is common in older adults with heart failure. It is known to adversely affect outcomes.

Aim: To examine the associations of atrial fibrillation with 4-year mortality and 30-day readmission in older adults hospitalized with heart failure.

Diagnosis of heart failure in older adults: predictive value of dyspnea at rest.

The objective of this study was to describe the predictive value of dyspnea at rest in the diagnosis of heart failure in older adults. We have conducted a retrospective chart review of older adults hospitalized with heart failure in 11 hospitals in Alabama, US. We defined dyspnea at rest as dyspnea not accompanied by activities, sleep, or lying down.

Alabama coronary artery bypass grafting project: results from phase II of a statewide quality improvement initiative.

Objective/background: This report describes the first round of results for Phase II of the Alabama CABG Project, a regional quality improvement initiative.

Methods: Charts submitted by all hospitals in Alabama performing CABG (ICD-9 codes 36.10-36.

Predictors of nursing home admission for older adults hospitalized with heart failure.

The objective of this retrospective chart review study was to determine the prevalence and predictors of nursing home admission of older hospitalized heart failure patients. Subjects were Medicare beneficiaries discharged with a principal diagnosis of heart failure in 1994 in the state of Alabama, United States. The outcome variable was admission to a nursing home after hospital discharge.

Association of consultation between generalists and cardiologists with quality and outcomes of heart failure care.

Background: The appropriate roles for generalists and cardiologists in the care of patients with heart failure (HF) are unknown. The objective of this retrospective cohort study was to determine whether consultation between generalists and cardiologists was associated with better quality and outcomes of HF care.

Methods: We studied left ventricular function evaluation (LVFE) and angiotensin-converting enzyme inhibitor (ACEI) use and 90-day readmission and 90-day mortality rates in patients with HF who were hospitalized.

Heart failure mortality among older Medicare beneficiaries: association with left ventricular function evaluation and angiotensin-converting enzyme inhibitor use.

Background: Left ventricular function evaluation and angiotensin-converting enzyme (ACE) inhibitor use are the two basic indicators of heart failure quality of care. In this retrospective follow-up study, we analyzed the association between these two quality indicators and mortality in elderly hospitalized heart failure patients.

Methods: The patients in our study were older Alabama Medicare beneficiaries discharged with a diagnosis of heart failure in 1994.

Clinical correlates of isolated left ventricular diastolic dysfunction among hospitalized older heart failure patients.

Heart failure due to isolated left ventricular diastolic dysfunction (LVDD) is common among older adults. The purpose of this study was to develop a model based on admission clinical features to predict isolated LVDD in older adults hospitalized with heart failure. The authors studied 394 Alabama Medicare beneficiaries discharged with a primary discharge diagnosis of heart failure.

Racial variations in cardiology care among hospitalized older heart failure patients.

In this retrospective follow-up study, the authors examined the association between race and the receipt of cardiology care in 1062 Medicare beneficiaries 65 years of age and older who were hospitalized with heart failure. The primary outcome measure was receipt of care from a cardiologist (via admission or consultation). Using logistic regression analyses, crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI) of receipt of cardiology care were estimated for nonwhite versus white patients.

Quality of care of nursing home residents hospitalized with heart failure.

Objectives: To determine whether the quality of heart failure (HF) care of hospitalized nursing home (NH) residents is different from that of patients admitted from other locations.

Design: Retrospective chart review.

Setting: Nursing home residents discharged from hospitals.

Survival benefits of angiotensin-converting enzyme inhibitors in older heart failure patients with perceived contraindications.

Objectives: To determine the association between angiotensin-converting enzyme (ACE) inhibitor therapy and survival of older heart failure patients with conditions perceived by physicians as contraindications to ACE inhibitors.

Setting: Hospital.

Design: Retrospective follow-up study.

Correlates and outcomes of preserved left ventricular systolic function among older adults hospitalized with heart failure.

Background: Heart failure (HF) in older adults is often associated with preserved left ventricular systolic function (LVSF). The objective of this retrospective follow-up study was to determine the correlates and outcomes of preserved LVSF among older adults hospitalized with HF.

Methods: We studied older Medicare beneficiaries hospitalized with HF (n = 1091) who had documented LVSF evaluation (n = 438).

Age-related underutilization of angiotensin-converting enzyme inhibitors in older hospitalized heart failure patients.

Background: The extent to which age plays a role in the underutilization of angiotensin-converting enzyme (ACE) inhibitors in heart failure patients has not been well studied.

Methods: We studied age-related variation in the use of ACE inhibitors in older Medicare beneficiaries discharged alive in Alabama with a diagnosis of heart failure with left ventricular systolic dysfunction.

Results: A total of 285 patients had a mean age +/- SD of 78 +/- 6.

Age-related underutilization of left ventricular function evaluation in older heart failure patients.

Background: Underutilization of left ventricular function (LVF) evaluation in older patients with heart failure has been well documented, but age-related variation in the use of LVF evaluation has not been.

Methods: We studied age-related variation of LVF evaluation in older Medicare-beneficiaries discharged with a diagnosis of heart failure in 1994 in Alabama.

Results: A total of 1,090 patients had a mean +/- SD age of 79 +/- 7.

Inappropriate use of digoxin in older hospitalized heart failure patients.

Background: Older adults are more likely to suffer from the adverse effects of digoxin. Studies have described the inappropriate use of digoxin in various populations. The objective of this study was to determine the correlates of inappropriate digoxin use in older heart failure patients.