Epidemiology Of Transition For Stage D Heart Failure

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

This study used a descriptive, correlational, comparative and quantitative design to determine the probable causes of heart failure readmissions (Anderson, 2014). Independent t tests were used to the characteristics between those individuals that were readmitted and those that were not. Correlation coefficients were examined using the Pearson product-moment and the Spearman ρ test to determine the indications for readmission. (Anderson, 2014). Once these were established the Hosmer and Lemeshow tests were used in binary logistical regression analysis to determine how well each predictor variable determined the probability of readmission. Using these tests, the results showed that P=0.599, indicating that the model adequately fits the data (Anderson, 2014). To add to this, further proving the study’s validity, a hierarchical approach was preferred because “entry of variables is based upon an evaluation of theoretic, clinical, and statistical considerations” (Anderson, 2014, p. 234). This allowed for the assessment of predictive ability. This study through multiple statistical tests proved strong validity in its data collection, research design, and measurement

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

The chronic disease burden has increased the need for a statewide and national approach in its detection, prevention, and treatment of heart failure. In the state of Indiana heart disease is shown to be leading the way with a total of 13,394 individuals who have died in 2013 (Indiana State, 2013). The health indicators show that although the mortality rate has decreased from 42.3 per 100,000 in 2001 to 37.3 per 100,000 hospitalization rates have increased (Center for Disease, 2011). Heart failure rehospitalization rate has increased from 2007-2011 especially in those who are over the age of 85. In 2011, there were a total of 41.9 per 1,000 hospitalizations due to heart failure. This is gradually increasing from the Healthy People 2020

Congestive Heart Failure (CHF) is a foremost health problem worldwide, touching 4.8 million U.S. patients and accounts for 978,000 or 5-10% of all hospitalizations. Some estimates show 550,000 new cases of CHF diagnosed each year in the United States alone. Currently, CHF accounts for 20% of all discharges in the over age 65 categories; with the aging demographic, this statistic is expected to increase significantly. Overall, the cost of treating CHF is very high -$38 billion annually in the U.S., representing 5.4% of total health care costs and involves many physician visits - at least 11 million ambulatory visits per year. The mortality rate for CHF is high, with one in five persons dying within 1 year, more than half of the CHF patients

One of the most important aspects of treating a patient with heart failure is providing an ample amount of education and counseling to both the patient and their family. It is essential that the patient understands the importance of participating in their treatment regimen and that it is a lifelong commitment that they must actively be involved with in managing their care (Hinkle & Cheever, 2014, p.800).

Heart disease is the leading cause of death in the United States and the estimated cost of treatment is $32 billion yearly. Approximately 5 million people living in the United States suffer from congestive heart failure (CHF) and half of those diagnosed will die within 5 years. The quality and length of life for someone suffering from heart failure can be improved with early diagnosis, medication, physical activity, and diet modification (CDC, 2013). Congestive heart failure continues to account for more health care cost and readmissions than any other illness. The increase in the prevalence of CHF is contributed to the percentage of elderly population. Adherence to performance measures can increase patient outcomes (Mazimba, Grant, Parikh, Mwandia, Makola, Chilomo, Redko, & Hahn, 2012).

Acute-decompensated heart failure (ADHF) is one of the most frequent diagnoses in patients who attend emergency departments (EDs) worldwide, especially in Western countries1,2. In Spain, ADHF constitutes the leading cause of medical hospitalization through EDs3. Despite the substantial resource and economic implications of hospitalization, the final decision of emergency physicians to admit ADHF patients mainly relies on their subjective and personal clinical experience rather than on objective-supported evidence4,5. This decision is complex and challenging, as a wide spectrum of clinical presentations ranging from minor forms of decompensation to life-threatening illness can be observed in ADHF, and these are often complicated by the presence

Heart failure is a debilitating syndrome that has driven up health care costs (O’Donovan, 2014). Therefore, making heart failure one of the most expensive chronic diseases. Heart failure is one of the most prevalent chronic diseases in the U.S. It is the only cardiovascular disorder that is increasing in both incidence and prevalence (Park, Wortmann, & Edmondson, 2011). The current treatment for heart failure is known to improve survival, but the quality of life may be compromised. Routine implementation of clinical guidelines may lead to a standardization of care, which could affect the patient-centered care that is needed in today’s healthcare (Sanders, Harrison, & Checkland, 2010). It is imperative that each patient’s care plan be

In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)

It is noteworthy that, in addition to its discovery RDW prognosis of patients with heart failure on admission, there are found changes RDW during hospitalization cases [7], as well as discharge RDW test results [13,16] and also the prognosis of heart failure related. These studies were meta-analysis [19] showed that: RDW increased per unit (ie 1%), patients with all-cause mortality risk increased 1.1 times, but there are between existing research publication bias, indicating the existing research may exaggerate RDW prognostic value in heart failure. In addition to heart failure as a prognostic factor, RDW can also serve as a risk factor for heart failure. For example Borné et al [20] of 26 784 community residents for more than 10 years of follow-up, observed the research object of baseline RDW and the relationship between the cardiovascular events in the future. The researchers found that the correction for blood pressure, smoking, lipoprotein and other known risk factors for cardiovascular disease, RDW still closely related to the occurrence of heart failure risk, the higher performance for baseline RDW, the individual risk of future heart failure also higher. Tonelli et al [21] of 4111 patients with CHD were 6 years of follow-up found that in patients with coronary heart disease, RDW prompted increased risk in patients