640 Application of the Seattle Heart Failure Model in an Elderly Population Enrolled in a Tertiary Care Heart Failure Clinic

Abstract

BackgroundThe Seattle Heart Failure Model (SHFM) is one of the most widely used tools to predict survival in heart failure patients. It does not, however, accommodate very elderly patients. We decided to assess the applicability of the SHFM in patients above the age of 80 enrolled in a tertiary care Heart Failure clinic.Methods/ResultsWe evaluated the difference between actual survival and mean life expectancy (MLE) as predicted by the SHFM on 175 deceased patients above the age of 80 enrolled in Heart Failure Clinic at the Jewish General Hospital, Montréal, Québec, Canada between January 2002 and March 2010. The average age of the patient population was 85.5 ± 4.2 (range 80 - 105) years. Sixty-nine percent of the population was male, 63% had ischemic cardiomyopathy and 52% were NYHA class III at registration with an average ejection fraction of 36 ± 18%. Average survival was 1.6 ± 1.6 years. The SHFM consistently overestimated life expectancy in this population by an average of 3.9 ± 3.1 years (r = 0.25, p = 000) with an overestimation of survival by ≥ 2 years in 69% of the population.ConclusionsThe SHFM overestimates life expectancy in the elderly patient followed in tertiary care heart failure clinic. Further studies are needed to more accurately estimate prognosis in this patient population. BackgroundThe Seattle Heart Failure Model (SHFM) is one of the most widely used tools to predict survival in heart failure patients. It does not, however, accommodate very elderly patients. We decided to assess the applicability of the SHFM in patients above the age of 80 enrolled in a tertiary care Heart Failure clinic. The Seattle Heart Failure Model (SHFM) is one of the most widely used tools to predict survival in heart failure patients. It does not, however, accommodate very elderly patients. We decided to assess the applicability of the SHFM in patients above the age of 80 enrolled in a tertiary care Heart Failure clinic. Methods/ResultsWe evaluated the difference between actual survival and mean life expectancy (MLE) as predicted by the SHFM on 175 deceased patients above the age of 80 enrolled in Heart Failure Clinic at the Jewish General Hospital, Montréal, Québec, Canada between January 2002 and March 2010. The average age of the patient population was 85.5 ± 4.2 (range 80 - 105) years. Sixty-nine percent of the population was male, 63% had ischemic cardiomyopathy and 52% were NYHA class III at registration with an average ejection fraction of 36 ± 18%. Average survival was 1.6 ± 1.6 years. The SHFM consistently overestimated life expectancy in this population by an average of 3.9 ± 3.1 years (r = 0.25, p = 000) with an overestimation of survival by ≥ 2 years in 69% of the population. We evaluated the difference between actual survival and mean life expectancy (MLE) as predicted by the SHFM on 175 deceased patients above the age of 80 enrolled in Heart Failure Clinic at the Jewish General Hospital, Montréal, Québec, Canada between January 2002 and March 2010. The average age of the patient population was 85.5 ± 4.2 (range 80 - 105) years. Sixty-nine percent of the population was male, 63% had ischemic cardiomyopathy and 52% were NYHA class III at registration with an average ejection fraction of 36 ± 18%. Average survival was 1.6 ± 1.6 years. The SHFM consistently overestimated life expectancy in this population by an average of 3.9 ± 3.1 years (r = 0.25, p = 000) with an overestimation of survival by ≥ 2 years in 69% of the population. ConclusionsThe SHFM overestimates life expectancy in the elderly patient followed in tertiary care heart failure clinic. Further studies are needed to more accurately estimate prognosis in this patient population. The SHFM overestimates life expectancy in the elderly patient followed in tertiary care heart failure clinic. Further studies are needed to more accurately estimate prognosis in this patient population.