Key result
Prior year's health status and comorbidity were powerful predictors of subsequent health status and mortality in older patients with heart failure, with 18% of patients dying over 1 year.
Cohort (n=872)
In older patients with heart failure, prior health status and comorbidities are strong predictors of subsequent functional status and mortality.
Supports prognosis discussions using prior status in older HF; leaves open whether interventions based on these predictors improve outcomes.
BACKGROUND: We aimed to determine transitions in health perception and functional status in older Medicare patients with heart failure. METHODS: We used 1991 to 1994 data from the Medicare Current Beneficiary Survey, a database that combines Medicare claims with yearly longitudinal surveys. We identified 872 patients 65 years or older in 1991 with a diagnostic code of heart failure. RESULTS: At baseline, 58% of the patients rated their general health perception as "fair" or "poor." Over 1 year, 18% of the patients died. Transition matrices revealed that health perception, activities of daily living, and instrumental activities of daily living were strong correlates of mortality; that dramatic changes in health status were relatively uncommon over 1 year among survivors; and that decline was common in patients with "excellent" or "very good" health perception. The prior year's health status and comorbidity were powerful predictors of the subsequent year's health status. CONCLUSION: Many older patients with heart failure have worsening health status over time. Measures of prior health status can help predict chances of functional recovery.
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Chin et al. (2003) conducted a cohort in Heart failure (n=872). Prior year's health status and comorbidity were powerful predictors of subsequent health status and mortality in older patients with heart failure, with 18% of patients dying over 1 year.
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