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Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE) - 21/08/11

Doi : 10.1016/j.ahj.2004.08.005 
Kirkwood F. Adams, MD a, , Gregg C. Fonarow, MD b, Charles L. Emerman, MD c, Thierry H. LeJemtel, MD d, Maria Rosa Costanzo, MD e, William T. Abraham, MD f, Robert L. Berkowitz, MD, PhD g, Marie Galvao, MSN, ANP-C h, Darlene P. Horton, MD i

for the ADHERE Scientific Advisory Committee and Investigators 1

  The ADHERE Scientific Advisory Committee members are listed in Appendix A.

a Division of Cardiology, University of North Carolina, Chapel Hill, NC 
b Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, Calif 
c Department of Emergency Medicine, Case Western Reserve University, Cleveland, Ohio 
d Cardiology Division, Albert Einstein Hospital, Bronx, NY 
e Midwest Heart Specialists, Edward Hospital, Naperville, Ill 
f Division of Cardiology, The Ohio State University Heart Center, Columbus, Ohio 
g Heart Failure Program, Hackensack University Hospital, Hackensack, NJ 
h Congestive Heart Failure Program, Montefiore Medical Center, Bronx, NY 
i Senior Vice President of Clinical Research and Medical Affairs, Scios Inc., Fremont, Calif 

Reprint requests: Kirkwood F. Adams, Jr, MD, UNC Heart Failure Program, Suite 207, 730 Airport Road, Chapel Hill, NC 27514-5738.

The ADHERE is sponsored by Scios Inc.

Riassunto

Background

The ADHERE is designed to study characteristics, management, and outcomes in a broad sample of patients hospitalized with acute decompensated heart failure. Heart failure is a leading cause of hospitalization for adults older than 65 years in the United States. Most available data on these patients are limited by patient selection criteria and study design of clinical trials and single-center studies.

Methods

Participating hospitals identify patients with a primary or secondary discharge diagnosis of heart failure. Medical history, management, treatments, and health outcomes data are collected through review of medical records and entered into a database via secure web browser technology.

Results

As of January 2004, data on 107362 patients have been received from 282 participating hospitals. Of enrollees with available analyzable data (N = 105388 from 274 hospitals), the mean age was 72.4 (±14.0), and 52% were women. The most common comorbid conditions were hypertension (73%), coronary artery disease (57%), and diabetes (44%). Evidence of mild or no impairment of systolic function was found in 46% of patients. Inhospital mortality was 4.0% and the median hospital length of stay was 4.3 days.

Conclusions

The ADHERE demonstrates both the feasibility and significant implications of gathering representative data on large numbers of patients hospitalized with heart failure. Initial data provided important insights into the clinical characteristics and patterns of care of these patients. Ongoing registry work will provide the framework for improved treatment strategies for patients hospitalized with decompensated heart failure.

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© 2005  Pubblicato da Elsevier Masson SAS.
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Vol 149 - N° 2

P. 209-216 - Febbraio 2005 Ritorno al numero
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