TY - JOUR
T1 - Association Between Conformity With Performance Measures and 1-Year Postdischarge Survival in Patients With Acute Decompensated Heart Failure
AU - Scrutinio, Domenico
AU - Passantino, Andrea
AU - Ricci, Vito Antonio
AU - Catanzaro, Raffaella
PY - 2013
Y1 - 2013
N2 - Recognition of the treatment gap in patients with heart failure (HF) led to the development of a set of process-of-care measures to improve the quality of care. To assess the association of established and emerging process-of-care measures with 1-year postdischarge survival, 496 patients with acute decompensated HF were studied. After adjustment for established prognostic factors, the relative risk (RR) for mortality in patients eligible for treatment was as follows: 0.49 (P <.001) for discharge prescription of renin-angiotensin system inhibitors (RAS-Is), 0.59 (P = .015) for β-blockers, 0.44 (P <.001) for combination therapy (ie, a β-blocker and a RAS-I), 0.87 (P nonsignificant) for aldosterone antagonists, and 0.49 (P nonsignificant) for planned cardioverter-defibrillator implantation. After adjustment for propensity scores, the RR was 0.49 (P <.001) for RAS-Is, 0.67 (P = .04) for β-blockers, and 0.57 (P <.001) for combination therapy. The data suggest that performance measures for RAS-Is, β-blockers, and combination therapy are strongly associated with improved 1-year survival.
AB - Recognition of the treatment gap in patients with heart failure (HF) led to the development of a set of process-of-care measures to improve the quality of care. To assess the association of established and emerging process-of-care measures with 1-year postdischarge survival, 496 patients with acute decompensated HF were studied. After adjustment for established prognostic factors, the relative risk (RR) for mortality in patients eligible for treatment was as follows: 0.49 (P <.001) for discharge prescription of renin-angiotensin system inhibitors (RAS-Is), 0.59 (P = .015) for β-blockers, 0.44 (P <.001) for combination therapy (ie, a β-blocker and a RAS-I), 0.87 (P nonsignificant) for aldosterone antagonists, and 0.49 (P nonsignificant) for planned cardioverter-defibrillator implantation. After adjustment for propensity scores, the RR was 0.49 (P <.001) for RAS-Is, 0.67 (P = .04) for β-blockers, and 0.57 (P <.001) for combination therapy. The data suggest that performance measures for RAS-Is, β-blockers, and combination therapy are strongly associated with improved 1-year survival.
KW - acute decompensated heart failure
KW - performance measures
KW - survival
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U2 - 10.1177/1062860612451049
DO - 10.1177/1062860612451049
M3 - Article
C2 - 22822168
AN - SCOPUS:84874774500
VL - 28
SP - 160
EP - 168
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
SN - 1062-8606
IS - 2
ER -