Heart failure is the leading cause of hospitalization in North America, and for patients hearing the diagnosis, the first thing they want to know is: "How long do I have, doctor?"
Now doctors say they can better provide that answer following a large study conducted on Ontario heart failure patients.
And the short answer? Somewhere around 29 months.
The term "heart failure" can be confusing for many patients. It doesn't mean your heart has stopped or that you are having a heart attack - though people with heart failure often have had a heart attack in the past.
It means that your heart is deteriorating and is no longer pumping blood as well as it should. It is really the end result of a variety of cardiovascular problems that begin when heart tissue is damaged from clogged arteries, high blood pressure, or other causes.
The five most common causes of heart failure are:
- coronary artery disease (due to atherosclerosis)
- valvular heart disease
- high blood pressure
- alcohol
- and a disease of heart muscle known as dilated cardiomyopathy.
The lead author of this Canadian study, Dr. Dennis Ko, a scientist with ICES (Institute for Clinical Evaluative Sciences) says heart failure is a very serious condition with a high death rate in the elderly and a survival rate worse than many aggressive cancers.
Ko's team looked at almost 10,000 Ontario patients who were hospitalized between 1999 and 2001 and newly diagnosed with heart failure. The average age of the patients was 75 and half were female.
They followed these patients over a six-year period to see how they did over time. They found that the average survival among hospitalized heart failure patients was 2.4 years (29 months). But survival varied substantially, depending on the patient.
Those patients seen as high risk (because of advanced age, poor vital signs or other health conditions) had an average survival of eight months. Those patients considered very high risk had an average survival of three months.
About a third of all the patients could be expected to die within a year and two-thirds died with five years.
The results are published in this month's issue of American Heart Journal.
"Physicians and patients had little understanding of prognosis after hospitalization, this information is crucial to identify patients who may not be suitable for invasive treatment," Dr. Ko said of his study.
"For the first time, we have a better picture of expected survival in this category of patients and who may benefit for palliative or end of life care."
Dr. Ko hopes that with this detailed life expectancy data, doctors and heart failure patients can now make more informed treatment decisions that will focus on improving the quality of the patients' lives in their final months.
