Skip to main content
Top
Published in: BMC Geriatrics 1/2015

Open Access 01-12-2015 | Research article

Heart failure in nursing home residents; a cross-sectional study to determine the prevalence and clinical characteristics

Authors: Mariëlle A. M. J. Daamen, Jan P. H. Hamers, Anton P. M. Gorgels, Hans-Peter Brunner-La Rocca, Frans E. S. Tan, Marja P. van Dieijen-Visser, Jos M. G. A. Schols

Published in: BMC Geriatrics | Issue 1/2015

Login to get access

Abstract

Background

Heart failure (HF) is expected to be highly prevalent in nursing home residents, but precise figures are scarce. The aim of this study was to determine the prevalence of HF in nursing home residents and to get insight in the clinical characteristics of residents with HF.

Methods

The study followed a multi-centre cross-sectional design.
Nursing home residents (n = 501) in the southern part of the Netherlands aged over 65 years and receiving long-term somatic or psychogeriatric care were included in the study. The diagnosis of HF and related characteristics were based on data collected from actual clinical examinations (including history, physical examination, ECG, cardiac markers and echocardiography), patient records and questionnaires. A panel of two cardiologists and a geriatrician ultimately judged the data to diagnose HF.

Results

The overall prevalence of HF in nursing home residents was 33 %, of which 52 % had HF with preserved ejection fraction. The symptoms dyspnoea and oedema and a cardiac history were more common in residents with HF. Diabetes mellitus, chronic obstructive pulmonary disease (COPD) were also more prevalent in those with HF. Residents with HF had a higher score on the Mini Mental State Examination. 54 % of those with HF where not known before, and in 31 % with a history of HF, this diagnosis was not confirmed by the expert panel.

Conclusion

This study shows that HF is highly prevalent in nursing home residents with many unknown or falsely diagnosed with HF. Equal number of HF patients had reduced and preserved left-ventricular ejection fraction.

Trial registration

The Netherlands National Trial Register NTR2663 (27-12-2010)
Literature
1.
go back to reference Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J. 2004;25(18):1614–9.CrossRefPubMed Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J. 2004;25(18):1614–9.CrossRefPubMed
2.
3.
go back to reference Jugdutt BI. Prevention of heart failure in the elderly: when, where and how to begin? Heart Fail Rev. 2012;17(4–5):531–44.CrossRefPubMed Jugdutt BI. Prevention of heart failure in the elderly: when, where and how to begin? Heart Fail Rev. 2012;17(4–5):531–44.CrossRefPubMed
4.
go back to reference Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.CrossRefPubMed Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.CrossRefPubMed
5.
go back to reference Kaila K, Haykowsky MJ, Thompson RB, Paterson DI. Heart failure with preserved ejection fraction in the elderly: scope of the problem. Heart Fail Rev. 2012;17(4–5):555–62.CrossRefPubMed Kaila K, Haykowsky MJ, Thompson RB, Paterson DI. Heart failure with preserved ejection fraction in the elderly: scope of the problem. Heart Fail Rev. 2012;17(4–5):555–62.CrossRefPubMed
6.
go back to reference Gaulden L. Diagnosis and management of heart failure in the long-term care setting. Director. 2003;11(4):177–81.PubMed Gaulden L. Diagnosis and management of heart failure in the long-term care setting. Director. 2003;11(4):177–81.PubMed
7.
go back to reference Ruths S, Straand J, Nygaard HA, Hodneland F. Drug treatment of heart failure--do nursing-home residents deserve better? Scand J Prim Health Care. 2000;18(4):226–31.CrossRefPubMed Ruths S, Straand J, Nygaard HA, Hodneland F. Drug treatment of heart failure--do nursing-home residents deserve better? Scand J Prim Health Care. 2000;18(4):226–31.CrossRefPubMed
8.
go back to reference Schols JM, Crebolder HF, van Weel C. Nursing home and nursing home physician: the Dutch experience. J Am Med Dir Assoc. 2004;5(3):207–12.CrossRefPubMed Schols JM, Crebolder HF, van Weel C. Nursing home and nursing home physician: the Dutch experience. J Am Med Dir Assoc. 2004;5(3):207–12.CrossRefPubMed
9.
go back to reference Oudejans I, Mosterd A, Bloemen JA, Valk MJ, van Velzen E, Wielders JP, et al. Clinical evaluation of geriatric outpatients with suspected heart failure: value of symptoms, signs, and additional tests. Eur J Heart Fail. 2011;13(5):518–27.CrossRefPubMed Oudejans I, Mosterd A, Bloemen JA, Valk MJ, van Velzen E, Wielders JP, et al. Clinical evaluation of geriatric outpatients with suspected heart failure: value of symptoms, signs, and additional tests. Eur J Heart Fail. 2011;13(5):518–27.CrossRefPubMed
10.
go back to reference Rutten FH, Cramer MJ, Grobbee DE, Sachs AP, Kirkels JH, Lammers JW, et al. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. Eur Heart J. 2005;26(18):1887–94.CrossRefPubMed Rutten FH, Cramer MJ, Grobbee DE, Sachs AP, Kirkels JH, Lammers JW, et al. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. Eur Heart J. 2005;26(18):1887–94.CrossRefPubMed
11.
go back to reference Iacoviello M, Antoncecchi V. Heart failure in elderly: progress in clinical evaluation and therapeutic approach. Journal of geriatric cardiology : JGC. 2013;10(2):165–77.PubMedPubMedCentral Iacoviello M, Antoncecchi V. Heart failure in elderly: progress in clinical evaluation and therapeutic approach. Journal of geriatric cardiology : JGC. 2013;10(2):165–77.PubMedPubMedCentral
12.
go back to reference Daamen MA, Schols JM, Jaarsma T, Hamers JP. Prevalence of heart failure in nursing homes: a systematic literature review. Scand J Caring Sci. 2010;24(1):202–8.CrossRefPubMed Daamen MA, Schols JM, Jaarsma T, Hamers JP. Prevalence of heart failure in nursing homes: a systematic literature review. Scand J Caring Sci. 2010;24(1):202–8.CrossRefPubMed
13.
go back to reference Butler R, Fonseka S, Barclay L, Sembhi S, Wells S. The health of elderly residents in long term care institutions in New Zealand. N Z Med J. 1999;112(1099):427–9.PubMed Butler R, Fonseka S, Barclay L, Sembhi S, Wells S. The health of elderly residents in long term care institutions in New Zealand. N Z Med J. 1999;112(1099):427–9.PubMed
14.
go back to reference Hancock HC, Close H, Mason JM, Murphy JJ, Fuat A, Singh R, et al. High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study. Eur J Heart Fail. 2013;15(2):158–65.CrossRefPubMed Hancock HC, Close H, Mason JM, Murphy JJ, Fuat A, Singh R, et al. High prevalence of undetected heart failure in long-term care residents: findings from the Heart Failure in Care Homes (HFinCH) study. Eur J Heart Fail. 2013;15(2):158–65.CrossRefPubMed
15.
go back to reference Daamen MA, Hamers JP, Gorgels AP, Brunner-la Rocca HP, Tan FE, van Dieijen-Visser MP, et al. The prevalence and management of heart failure in Dutch nursing homes; design of a multi-centre cross-sectional study. BMC Geriatr. 2012;12:29.CrossRefPubMedPubMedCentral Daamen MA, Hamers JP, Gorgels AP, Brunner-la Rocca HP, Tan FE, van Dieijen-Visser MP, et al. The prevalence and management of heart failure in Dutch nursing homes; design of a multi-centre cross-sectional study. BMC Geriatr. 2012;12:29.CrossRefPubMedPubMedCentral
16.
17.
go back to reference Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRefPubMed Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRefPubMed
18.
go back to reference O’Keefe Jr J, Hammill S, Freed M, Poqwizd S. The ECG Criteria Book. 2nd ed. Sudbury: Jones and Bartlett Publishers; 2011. O’Keefe Jr J, Hammill S, Freed M, Poqwizd S. The ECG Criteria Book. 2nd ed. Sudbury: Jones and Bartlett Publishers; 2011.
19.
go back to reference Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):1810–52.CrossRefPubMed Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):1810–52.CrossRefPubMed
20.
go back to reference McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–847.CrossRefPubMed McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–847.CrossRefPubMed
21.
go back to reference Cowie MR, Mosterd A, Wood DA, Deckers JW, Poole-Wilson PA, Sutton GC, et al. The epidemiology of heart failure. Eur Heart J. 1997;18(2):208–25.CrossRefPubMed Cowie MR, Mosterd A, Wood DA, Deckers JW, Poole-Wilson PA, Sutton GC, et al. The epidemiology of heart failure. Eur Heart J. 1997;18(2):208–25.CrossRefPubMed
22.
go back to reference Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Suresh V, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999;20(6):421–8.CrossRefPubMed Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Suresh V, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999;20(6):421–8.CrossRefPubMed
23.
go back to reference Barents M, van der Horst IC, Voors AA, Hillege JL, Muskiet FA, de Jongste MJ. Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J. 2008;16(4):123–8.CrossRefPubMedPubMedCentral Barents M, van der Horst IC, Voors AA, Hillege JL, Muskiet FA, de Jongste MJ. Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J. 2008;16(4):123–8.CrossRefPubMedPubMedCentral
24.
go back to reference Pressler SJ, Subramanian U, Kareken D, Perkins SM, Gradus-Pizlo I, Sauve MJ, et al. Cognitive deficits in chronic heart failure. Nurs Res. 2010;59(2):127–39.CrossRefPubMedPubMedCentral Pressler SJ, Subramanian U, Kareken D, Perkins SM, Gradus-Pizlo I, Sauve MJ, et al. Cognitive deficits in chronic heart failure. Nurs Res. 2010;59(2):127–39.CrossRefPubMedPubMedCentral
25.
go back to reference Zuccala G, Pedone C, Cesari M, Onder G, Pahor M, Marzetti E, et al. The effects of cognitive impairment on mortality among hospitalized patients with heart failure. Am J Med. 2003;115(2):97–103.CrossRefPubMed Zuccala G, Pedone C, Cesari M, Onder G, Pahor M, Marzetti E, et al. The effects of cognitive impairment on mortality among hospitalized patients with heart failure. Am J Med. 2003;115(2):97–103.CrossRefPubMed
26.
go back to reference Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355(3):251–9.CrossRefPubMed Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355(3):251–9.CrossRefPubMed
27.
go back to reference Tribouilloy C, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J. 2008;29(3):339–47.CrossRefPubMed Tribouilloy C, Rusinaru D, Mahjoub H, Souliere V, Levy F, Peltier M, et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J. 2008;29(3):339–47.CrossRefPubMed
28.
go back to reference Kaufmann BA, Min SY, Goetschalckx K, Bernheim AM, Buser PT, Pfisterer ME, et al. How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure? Int J Cardiovasc Imaging. 2013;29(3):581–8.CrossRefPubMed Kaufmann BA, Min SY, Goetschalckx K, Bernheim AM, Buser PT, Pfisterer ME, et al. How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure? Int J Cardiovasc Imaging. 2013;29(3):581–8.CrossRefPubMed
29.
go back to reference Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett Jr JC, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–70.CrossRefPubMed Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, Burnett Jr JC, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–70.CrossRefPubMed
30.
go back to reference Barnes S, Gott M, Payne S, Parker C, Seamark D, Gariballa S, et al. Recruiting older people into a large, community-based study of heart failure. Chronic Illn. 2005;1(4):321–9.CrossRefPubMed Barnes S, Gott M, Payne S, Parker C, Seamark D, Gariballa S, et al. Recruiting older people into a large, community-based study of heart failure. Chronic Illn. 2005;1(4):321–9.CrossRefPubMed
Metadata
Title
Heart failure in nursing home residents; a cross-sectional study to determine the prevalence and clinical characteristics
Authors
Mariëlle A. M. J. Daamen
Jan P. H. Hamers
Anton P. M. Gorgels
Hans-Peter Brunner-La Rocca
Frans E. S. Tan
Marja P. van Dieijen-Visser
Jos M. G. A. Schols
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2015
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-015-0166-1

Other articles of this Issue 1/2015

BMC Geriatrics 1/2015 Go to the issue