Abstract:
BACKGROUND:There are no life-tables quantifying the average life-spans of post-hospitalized heart failure populations across various strata of risk. OBJECTIVE:To quantify the life-expectancies (i.e., average life-spans) of heart failure patients at the time of hospital discharge according to age, gender, predictive 30-day mortality heart failure risk index, and comorbidity burden. DESIGN:Population-based retrospective cohort study. SETTING:Ontario, Canada. PATIENTS:7,865 heart failure patients discharged from Ontario hospitals between 1999 and 2000. MEASUREMENTS:Data were obtained from the Enhanced Feedback for Effective Cardiac Treatment EFFECT provincial quality improvement initiative. All patients were linked to administrative data, and tracked longitudinally until March 31, 2010. Detailed clinical variables were obtained from medical chart abstraction, and death data were obtained from vital statistics. Average life-spans were calculated using Cox Proportion Hazards models in conjunction with the Declining Exponential Approximation of Life Expectancy (D.E.A.L.E) method to extrapolate life-expectancy, adjusting for age, gender, predicted 30-day mortality, left ventricular function and comorbidity, and was reported according to key prognostic risk-strata. RESULTS:The average life-span of the cohort was 5.5 years (STD +/- 10.0) ranging from 19.5 years for low-risk women of less than 50 years old to 2.9 years for high-risk octogenarian males. Average life-spans were lower by 0.13 years among patients with impaired as compared with preserved left ventricular function, and by approximately one year among patients with three or more as compared with no concomitant comorbidities. In total, 17.4 % and 27 % of patients had died within 6 months and 1 year respectively, despite having predicted life-spans exceeding one-year. LIMITATIONS:Data regarding changes in patient clinical status over time were unavailable. CONCLUSIONS:The development of risk-adjusted life-tables for heart failure populations is feasible and mirrored those with advanced malignant diseases. Average life span varied widely across clinical risk strata, and may be less accurate among those at or near their end of life.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Alter DA,Ko DT,Tu JV,Stukel TA,Lee DS,Laupacis A,Chong A,Austin PCdoi
10.1007/s11606-012-2072-ysubject
Has Abstractpub_date
2012-09-01 00:00:00pages
1171-9issue
9eissn
0884-8734issn
1525-1497journal_volume
27pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:To develop and evaluate a web-based curriculum to introduce first year medical students to the knowledge and attitudes necessary for working with limited English proficient (LEP) patients through interpreters. METHOD:Six hundred and forty first year medical students over 4 consecutive years took this curric...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0193.x
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Increasing the use of electronic medical records (EMR) has been suggested as an important strategy for improving healthcare safety. OBJECTIVE:To sequentially measure, evaluate, and respond to safety culture and practice safety concerns following EMR implementation. DESIGN:Safety culture was assessed using ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence and persistence of depression in patients with acute myocardial infarction (AMI) and the relationship between assessment modality and prevalence. DATA SOURCES:MEDLINE, Cochrane, CINAHL, PsycINFO, and EMBASE. REVIEW METHODS:A comprehensive search was conducted in March 2004 to ident...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2005.00269.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To assess factors associated with patient satisfaction with communication of mammography results and their understanding and ability to recall these results. DESIGN:Cross-sectional telephone survey. SETTING:Academic breast imaging center. PATIENTS:Two hundred ninety-eight patients who had either a screenin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2001.00509.x
更新日期:2001-03-01 00:00:00
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doi:10.1007/s11606-016-3745-8
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doi:10.1007/s11606-019-05236-8
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To summarize for clinicians recent epidemiologic evidence regarding medical risks of alcohol use for women. METHODS:MEDLINE and PsychINFO, 1990 through 1996, were searched using key words "women" or "woman," and "alcohol." MEDLINE was also searched for other specific topics and authors from 1980 through 1996...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1497.1998.cr187.x
更新日期:1998-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s11606-018-4328-7
更新日期:2018-05-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1046/j.1525-1497.2000.03379.x
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abstract:BACKGROUND:There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE:To describe a high-cost Medicare Advantage population and iden...
journal_title:Journal of general internal medicine
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596117
更新日期:1988-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s11606-014-3002-y
更新日期:2015-01-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-013-2665-0
更新日期:2014-02-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-006-0067-2
更新日期:2007-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1143-1
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Previous studies indicate that medical trainees frequently experience discrimination by patients. Little is known about effective strategies to teach trainees to respond to this discrimination. AIM:To create a workshop for first-year residents utilizing standardized patients to improve skills in responding ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04881-3
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS:Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005. METHODS:A clinical data mar...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-007-0336-8
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2009-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-008-0667-0
更新日期:2008-07-01 00:00:00
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journal_title:Journal of general internal medicine
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abstract:BACKGROUND:As the Veterans Health Administration (VHA) reorganizes providers into the patient-centered medical home, questions remain whether this model of care can demonstrate improved patient outcomes and cost savings. OBJECTIVE:We measured adoption of medical home features by VHA primary care clinics prior to wides...
journal_title:Journal of general internal medicine
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journal_title:Journal of general internal medicine
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abstract:BACKGROUND:Extension for Community Healthcare Outcomes (ECHO) and related models of medical tele-education are rapidly expanding; however, their effectiveness remains unclear. This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improve...
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更新日期:2019-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-07-01 00:00:00