Association Between Conformity With Performance Measures and 1-Year Postdischarge Survival in Patients With Acute Decompensated Heart Failure

Domenico Scrutinio, Andrea Passantino, Vito Antonio Ricci, Raffaella Catanzaro

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)160-168
Number of pages9
JournalAmerican Journal of Medical Quality
Volume28
Issue number2
DOIs
Publication statusPublished - 2013

Fingerprint

Heart Failure
Renin-Angiotensin System
Survival
Process Assessment (Health Care)
Mineralocorticoid Receptor Antagonists
Therapeutics
Propensity Score
Defibrillators
Quality of Health Care
Prescriptions
Mortality

Keywords

  • acute decompensated heart failure
  • performance measures
  • survival

ASJC Scopus subject areas

  • Health Policy

Cite this

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abstract = "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.",
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