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Editor's Correspondence
October 11, 1999

Smoking Is an Important Component in the Analysis of Heart Failure

Arch Intern Med. 1999;159(18):2225-2226. doi:

The excellent study by Croft and colleagues1 analyzed Medicare databases (MDBs) and described the 6-year probability of survival for older adults following their hospitalization for heart failure. One in 5 survived 6 years; one third died during the first year. Men had lower survival rates than women; white men had a 10% greater risk of death than black men.

The authors could only speculate on the possible determinants of observed differences in outcomes because of limitations in the information contained in the MDBs. The lack of patient data regarding functional status, severity of disease, and physiologic indicators limited their analyses. Another deficiency of the MDBs, not mentioned by Croft et al, was the absence of information regarding smoking and exposure to secondhand smoke of patients with heart failure. This deficiency made it difficult to interpret data regarding variation in prognosis.