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September 28, 2011

Hospitalization for Acute Heart Failure Syndromes

Author Affiliations

Author Affiliations: Division of Palliative Medicine, University of Calgary, Calgary, Alberta, Canada (Drs Simon and Slawnych) (jessica.simon@albertahealthservices.ca); and Libin Cardiovascular Institute, Calgary (Dr Howlett).

JAMA. 2011;306(12):1326-1327. doi:10.1001/jama.2011.529-a

To the Editor: We agree with Drs Gheorghiade and Peterson1 that hospitalization for acute heart failure (HF) syndromes offers a valuable opportunity to reassess and intervene to improve postdischarge outcomes. However, we feel it is also important to emphasize the high burden of cost and reduced quality of life in those affected. Kaul et al2 reported in a study of more than 30 000 Canadian patients who died with HF (mean age, 83 years) that more than 75% were hospitalized during the last 6 months of life and more than 50% died while in the hospital. While we agree with Gheorghiade and Peterson that many patients with end-stage HF may become candidates for advanced HF therapies such as left ventricular assist devices, others will not, placing emphasis on end-of-life issues. As such, we feel it is important to highlight 2 additional areas that hospitalization provides an opportunity to address.

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