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Medline ® Abstract for Reference 38

of 'Palliative care for patients with advanced heart failure: Indications and strategies'

38
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Patterns of comorbidity in older adults with heart failure: the Cardiovascular Research Network PRESERVE study.
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Saczynski JS, Go AS, Magid DJ, Smith DH, McManus DD, Allen L, Ogarek J, Goldberg RJ, Gurwitz JH
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J Am Geriatr Soc. 2013 Jan;61(1):26-33.
 
OBJECTIVES: To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R).
DESIGN: Cross-sectional cohort study.
SETTING: Four participating health plans within the National Heart, Lung, and Blood Institute-sponsored Cardiovascular Research Network.
PARTICIPANTS: All members aged 65 and older with HF based on hospital discharge and ambulatory visit diagnoses.
MEASUREMENTS: Participants with a LVEF of 50% or greater were classified as having HF-P. Presence of cardiac and noncardiac comorbidities was obtained from health plan administrative databases.
RESULTS: Of 23,435 individuals identified with HF and LVEF information, 53% (12,407) had confirmed HF-P (mean age 79.6; 60% female). More than three-quarters of the sample had three or more co-occurring conditions in addition to HF, and half had five or more cooccurring conditions. Participants with HF-P had a slightly higher burden of comorbidity than those with HF-R (mean 4.5 vs 4.4, P = .002). Patterns of how specific conditions co-occurred did not vary in participants with preserved or reduced systolic function.
CONCLUSION: There is a high degree of comorbidity and multiple morbidity in individuals with HF. The burden and pattern of comorbidity varies only slightly in individuals with preserved or reduced LVEF.
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Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts 01605, USA. Jane.saczynski@umassmed.edu
PMID