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Study: Heart failure patients struggle after hospital release

Posted June 1, 2010

Over the past 13 years, medications and quality of care have been improving for heart failure patients in hospitals, experts say. An increasing number are surviving their hospital stay, which doctors say has been shortened by four days.

Though success inside the hospital is better, it’s when patients leave that there is a concern.

"At a time when we were focusing on shortening that length of stay, we might have been actually worsening some of the outcomes for patients,” said Dr. Harlan Krumholz, of the Yale University School of Medicine.

Study shows patients struggle after leaving hospital Study shows patients struggle after leaving hospital

Those outcomes occurred within 30 days after patients left the hospital.

"What we found was that the risk of dying increased, the risk of needing to come back to the hospital because of worsening clinical conditions increased, the need for nursing home care increased. They were losing ground in this period, outcomes were worsening,” Krumholz said.

Krumholz and other researchers studied more than 6 million fee-for-service Medicare patients hospitalized for heart failure between 1993 and 2006.

“There was a 50 percent increase in sending people to nursing homes. Also, there was a marked increase in the amount of times people needed to come back to be re-hospitalized, so that was almost a 20 percent increase,” he said. "We didn't do so well over the last 14 years in improving the outcomes at that critical juncture.”

The study appears in the Journal of the American Medical Association.

Researchers say, going forward, it's important to look at all aspects of care, not just what happens to heart failure patients while they're hospitalized.

3 Comments

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  • Malcontent Jun 3, 2:26 p.m.

    I know the staff at Wake Med. take the time to educate patients on how to take better care of themselves after the patient leaves. That's what happened to my dad. I think because of that, and the changes he made, my dad lived a few extra years. Before the heart attack, he ate a LOT of fatty stuff. After, he ate more salads and quit smoking. But, each and every situation is different...

  • kristalrose29 Jun 3, 2:11 p.m.

    My husband has CHF--the doctors kept trying to keep him in the hospital for tests and consultations with different doctors. People kept coming in telling us different things that only confused us. One nutritionist came in and told him that he needed to be on a "low carb" diet. Another one told him to eat lots of fruits and vegetables! (Carbs! Hello! But, they did tell him to stay away from sweets and baked goods) They thought he needed a sleep study, and respiratory therapy, and bariatric surgery,and home oxygen, and a disease specailist to look at his swollen legs (a side-product of heart failure--fluid builds up in the legs--something I figured out myself by researching online). Once he got out of the hospital, we switched cardiologists and we took the advice of both the new cardiologist and his regular medical doctor and lowered his sodium--less meat and bread products (hey, that's carbs too! LOL) He's doing better now, he's back to work, but still struggling medically.

  • CestLaVie Jun 2, 10:49 a.m.

    Good ole AMA and JAMA. Always looking out for their own, BEST interests. The heck with the patient...just send them home with little valuable info to better their lives & help them make changes from the previous mistakes that initially got them hospitalized.

    Did you teach them that all the meat, dairy, poultry, & seafood they've been brainwashed into eating all their lives is killing them or causing immense sickness?? Did you show them a better way to nourish their bodies through eating a concentration of veggies, fruits, seeds & beans so heart problems could be reversed by such a dietary change?? Or did you just concentrate on rest & walking or something simple like that?? Oh....maybe not even that?? I have a friend who experienced such a lack of advice.

    There ARE answers out there. They just can't be found at doctors' offices or pharmacies or hospitals. Try a health food store instead. Or a vegetarian magazine. Or a naturopathic physician. For starters!