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High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study

AIMS: Diagnosis of heart failure in older people in long-term care is challenging because of co-morbidities, cognitive deficit, polypharmacy, immobility, and poor access to services. This study aimed to ascertain heart failure prevalence and clinical management in this population. METHODS AND RESULT...

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Autores principales: Hancock, Helen C., Close, Helen, Mason, James M., Murphy, Jerry J., Fuat, Ahmet, Singh, Raj, Wood, Esther, de Belder, Mark, Brennan, Gill, Hussain, Nehal, Kumar, Nitin, Wilson, Doug, Hungin, A. Pali S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547366/
https://www.ncbi.nlm.nih.gov/pubmed/23112002
http://dx.doi.org/10.1093/eurjhf/hfs165
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author Hancock, Helen C.
Close, Helen
Mason, James M.
Murphy, Jerry J.
Fuat, Ahmet
Singh, Raj
Wood, Esther
de Belder, Mark
Brennan, Gill
Hussain, Nehal
Kumar, Nitin
Wilson, Doug
Hungin, A. Pali S.
author_facet Hancock, Helen C.
Close, Helen
Mason, James M.
Murphy, Jerry J.
Fuat, Ahmet
Singh, Raj
Wood, Esther
de Belder, Mark
Brennan, Gill
Hussain, Nehal
Kumar, Nitin
Wilson, Doug
Hungin, A. Pali S.
author_sort Hancock, Helen C.
collection PubMed
description AIMS: Diagnosis of heart failure in older people in long-term care is challenging because of co-morbidities, cognitive deficit, polypharmacy, immobility, and poor access to services. This study aimed to ascertain heart failure prevalence and clinical management in this population. METHODS AND RESULTS: A total of 405 residents, aged 65–100 years, in 33 UK care facilities were prospectively enrolled between April 2009 and June 2010. The presence of heart failure was determined using European Society of Cardiology guidelines, modified where necessary for immobility. Evaluation of symptoms and signs, functional capacity, and quality of life, portable on-site echocardiography, and medical record review were completed in 399 cases. The point prevalence of heart failure was 22.8% [n = 91, 95% confidence interval (CI) 18.8–27.2%]; of these, 62.7% (n = 57, 95% CI 59.6–66.5%) had heart failure with preserved ejection fraction and 37.3% had left ventricular systolic dysfunction (n = 34, 95% CI 34.8–40.5%). A total of 76% (n = 61) of previous diagnoses of heart failure were not confirmed, and up to 90% (n = 82) of study cases were new. No symptoms or signs were reliable predictors of heart failure. CONCLUSION: Heart failure was diagnosed in almost a quarter of residents: the prevalence was substantially higher than in other populations. The majority of heart failure cases were undiagnosed, while three-quarters of previously recorded cases were misdiagnosed. Common symptoms and signs appear to have little clinical utility in this population. Early, accurate differential diagnosis is key to the effective management of heart failure; this may be failing in long-term care facilities. TRIAL REGISTRATION: ISRCTN19781227
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spelling pubmed-35473662013-01-17 High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study Hancock, Helen C. Close, Helen Mason, James M. Murphy, Jerry J. Fuat, Ahmet Singh, Raj Wood, Esther de Belder, Mark Brennan, Gill Hussain, Nehal Kumar, Nitin Wilson, Doug Hungin, A. Pali S. Eur J Heart Fail Diagnosis AIMS: Diagnosis of heart failure in older people in long-term care is challenging because of co-morbidities, cognitive deficit, polypharmacy, immobility, and poor access to services. This study aimed to ascertain heart failure prevalence and clinical management in this population. METHODS AND RESULTS: A total of 405 residents, aged 65–100 years, in 33 UK care facilities were prospectively enrolled between April 2009 and June 2010. The presence of heart failure was determined using European Society of Cardiology guidelines, modified where necessary for immobility. Evaluation of symptoms and signs, functional capacity, and quality of life, portable on-site echocardiography, and medical record review were completed in 399 cases. The point prevalence of heart failure was 22.8% [n = 91, 95% confidence interval (CI) 18.8–27.2%]; of these, 62.7% (n = 57, 95% CI 59.6–66.5%) had heart failure with preserved ejection fraction and 37.3% had left ventricular systolic dysfunction (n = 34, 95% CI 34.8–40.5%). A total of 76% (n = 61) of previous diagnoses of heart failure were not confirmed, and up to 90% (n = 82) of study cases were new. No symptoms or signs were reliable predictors of heart failure. CONCLUSION: Heart failure was diagnosed in almost a quarter of residents: the prevalence was substantially higher than in other populations. The majority of heart failure cases were undiagnosed, while three-quarters of previously recorded cases were misdiagnosed. Common symptoms and signs appear to have little clinical utility in this population. Early, accurate differential diagnosis is key to the effective management of heart failure; this may be failing in long-term care facilities. TRIAL REGISTRATION: ISRCTN19781227 Oxford University Press 2013-02 2012-10-30 /pmc/articles/PMC3547366/ /pubmed/23112002 http://dx.doi.org/10.1093/eurjhf/hfs165 Text en © The Author 2012. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oup.com.
spellingShingle Diagnosis
Hancock, Helen C.
Close, Helen
Mason, James M.
Murphy, Jerry J.
Fuat, Ahmet
Singh, Raj
Wood, Esther
de Belder, Mark
Brennan, Gill
Hussain, Nehal
Kumar, Nitin
Wilson, Doug
Hungin, A. Pali S.
High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title_full High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title_fullStr High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title_full_unstemmed High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title_short High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study
title_sort high prevalence of undetected heart failure in long-term care residents: findings from the heart failure in care homes (hfinch) study
topic Diagnosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547366/
https://www.ncbi.nlm.nih.gov/pubmed/23112002
http://dx.doi.org/10.1093/eurjhf/hfs165
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