The Value of Admission Clinical Data for Diagnosing Heart Failure in Long-term Care.

Content Provider	Europe PMC
Author	Heckman, George A. Foebel, Andrea D. Dubin, Joel A. Ng, Jennifer Turpie, Irene D. Hussack, Patricia McKelvie, Robert S.
Copyright Year	2013
Abstract	BackgroundHeart failure (HF) is common in long-term care (LTC). Diagnostic uncertainty is important barrier to optimal HF management, stemming from inadequate health information transfer upon LTC admission. We determine the utility of admission clinical information to confirm a HF diagnosis in new LTC residents.MethodsThis was a prospective cohort study. From February 2004 to November 2006, information about new residents from 41 LTC homes in Ontario, Canada, was collected from residents and caregivers, and all available health records. A prior HF diagnosis was confirmed by consensus review of available data by two independent experts. Multivariate modelling was utilized to determine the utility of the admission clinical assessment in confirming a prior HF diagnosis.ResultsA total of 449 residents were included for analysis, aged 84.3±6.5 years, and 21.6% had a prior HF diagnosis. The most useful clinical item for diagnosing HF was a “history of HF”. The final model included “history of HF’ (OR [odds ratio] 13.66, 95% CI 6.61–28.24), “fluid on the lungs” (OR 2.01, 95% CI 1.04–3.89), “orthopnea” (OR 1.76, 95% CI 0.93–3.33), “taking β-blocker” (OR 2.09, 95% CI 1.10–3.94), “taking loop diuretics” (OR 2.11, 95% CI 1.12–3.98), and “history of coronary artery disease” (OR 2.83, 95% CI 1.42–5.64).ConclusionElements of the clinical assessment for new LTC residents can help confirm a prior HF diagnosis. An admission history of HF is highly predictive.
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Journal	Canadian Geriatrics Journal [Can Geriatr J]
Volume Number	16
DOI	10.5770/cgj.16.70
PubMed Central reference number	PMC3837714
Issue Number	4
PubMed reference number	24278092
e-ISSN	19258348
Language	English
Publisher	Canadian Geriatrics Society
Publisher Date	2013-12-03
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited. © 2013 Author(s). Published by the Canadian Geriatrics Society.
Subject Keyword	heart failure elderly nursing home long-term care diagnosis transition
Content Type	Text
Resource Type	Article
Subject	Gerontology Geriatrics and Gerontology