Palliative needs for heart failure or chronic obstructive pulmonary disease: Results of a multicenter observational registry

International Journal of Cardiology
Antonello GavazziAlberto Deales

Abstract

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) share a common organ failure trajectory marked by prognostic uncertainty, which is a barrier to appropriate provision of palliative care. We describe in a prospective cohort from specialist hospital services the epidemiology and late clinical course of these chronic diseases to trace criteria for transition to palliative care in the community. Seven centers enrolled 267 patients with advanced HF (n=174) or COPD (n=93) using common (multiple hospitalizations or severely impaired functional status or cachexia) and disease-specific (HF: systolic dysfunction, NYHA classes III-IV, end-organ hypoperfusion; COPD: very severe airflow obstruction, hypoxemia, hypercapnia, or long-term oxygen therapy) entry criteria. These patients represented 7.2% and 13% respectively of the overall HF and COPD population hospitalized during one year. They showed similar symptom burden, functional and quality of life impairment, recurrent hospitalizations, and 6-month mortality (39% and 37%, respectively). Organ failure progression was the cause of death in >75%. In-hospital overall stay during the previous year was the main mortality predictor in both. Disease-specific predictors includ...Continue Reading

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Oct 10, 2015·International Journal of Cardiology·Atsushi MizunoKoichiro Niwa
Jun 7, 2016·Journal of Pain and Symptom Management·Cristal L BrownAndrew J Muir
Sep 7, 2016·Heart Failure Reviews·Craig M AlpertEllen K Hummel
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Mar 13, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Ike IheanachoAfisi S Ismaila
Sep 10, 2020·Circulation. Heart Failure·Yuchieh Kathryn ChangDavid Hui
Jul 25, 2019·Current Pharmaceutical Design·Helen Edwards, Michael Bennett
Mar 20, 2021·The European Respiratory Journal·Jennifer PhilipDavid Hui

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