Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/35712
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Inglis, S. | - |
dc.contributor.author | Pearson, S. | - |
dc.contributor.author | Treen, S. | - |
dc.contributor.author | Gallasch, T. | - |
dc.contributor.author | Horowitz, J. | - |
dc.contributor.author | Stewart, S. | - |
dc.date.issued | 2006 | - |
dc.identifier.citation | Circulation, 2006; 114(23):2466-2473 | - |
dc.identifier.issn | 0009-7322 | - |
dc.identifier.issn | 1524-4539 | - |
dc.identifier.uri | http://hdl.handle.net/2440/35712 | - |
dc.description | © 2006 American Heart Association, Inc. | - |
dc.description.abstract | Background - The long-term impact of chronic heart failure management programs over the typical life span of affected individuals is unknown. Methods and Results - The effects of a nurse-led, multidisciplinary, home-based intervention (HBI) in a typically elderly cohort of patients with chronic heart failure initially randomized to either HBI (n=149) or usual postdischarge care (UC) (n=148) after a short-term hospitalization were studied for up to 10 years of follow-up (minimum 7.5 years of follow-up). Study end points were all-cause mortality, event-free survival (event was defined as death or unplanned hospitalization), recurrent hospital stay, and cost per life-year gained. Median survival in the HBI cohort was almost twice that of UC (40 versus 22 months; P<0.001), with fewer deaths overall (HBI, 77% versus 89%; adjusted relative risk, 0.74; 95% CI, 0.53 to 0.80; P<0.001). HBI was associated with prolonged event-free survival (median, 7 versus 4 months; P<0.01). HBI patients had more unplanned readmissions (560 versus 550) but took 7 years to overtake UC; the rates of readmission (2.04±3.23 versus 3.66±7.62 admissions; P<0.05) and related hospital stay (14.8±23.0 versus 28.4±53.4 days per patient per year; P<0.05) were significantly lower in the HBI group. HBI was associated with 120 more life-years per 100 patients treated compared with UC (405 versus 285 years) at a cost of $1729 per additional life-year gained when we accounted for healthcare costs including the HBI. Conclusions - In altering the natural history of chronic heart failure relative to UC (via prolonged survival and reduced frequency of recurrent hospitalization), HBI is a remarkably cost- and time-effective strategy over the longer term. | - |
dc.description.statementofresponsibility | Sally C. Inglis, Sue Pearson, Suzette Treen, Tamara Gallasch, John D. Horowitz, Simon Stewart | - |
dc.language.iso | en | - |
dc.publisher | Lippincott Williams & Wilkins | - |
dc.source.uri | http://dx.doi.org/10.1161/circulationaha.106.638122 | - |
dc.subject | cost-benefit analysis | - |
dc.subject | heart failure | - |
dc.subject | prevention | - |
dc.subject | prognosis | - |
dc.title | Extending the horizon in chronic heart failure: Effects of multidisciplinary, home-based intervention relative to usual care | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1161/CIRCULATIONAHA.106.638122 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Horowitz, J. [0000-0001-6883-0703] | - |
dc.identifier.orcid | Stewart, S. [0000-0001-9032-8998] | - |
Appears in Collections: | Aurora harvest 6 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.