ArticleJournal of the American College of Cardiology2022
Analysis of Worsening Heart Failure Events in an Integrated Health Care System.
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 56 citations in OpenAlex.
- The ALT FLOW early feasibility study 3-year results assessing left atrial to coronary sinus shunting in HFpEF.ESC heart failure · 2026Trial
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- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- Podcast Episode 1: A Pragmatic Overview of Heart Failure in Patients with Diabetes for Endocrinologists, Primary Care Physicians and Noncardiologist Clinicians.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Article
- Real-world incidence of cancer therapy-related cardiac dysfunction in a large, diverse, and contemporary cohort.ESC heart failure · 2026Article
- Worsening heart failure-based hierarchical endpoints beyond HF hospitalization: expert opinion paper.ESC heart failure · 2026Review
- Clinical risk prediction models for worsening heart failure events and all-cause mortality in adults with mild-to-moderate chronic kidney disease.ESC heart failure · 2026Article
- Vericiguat in heart failure with reduced ejection fraction: not vanity, but vindication.ESC heart failure · 2026Article
- Do I really need to be admitted? A case for more outpatient therapies for acute decompensated heart failure.Heart failure reviews · 2025Review
- Worsening versus advanced heart failure: Management and challenges.ESC heart failure · 2025Review
- A prospective analysis of management and outcomes of worsening heart failure in the outpatient setting.ESC heart failure · 2025Observational
- Clinical endpoints in pragmatic heart failure trials: From data collection to clinical endpoint classification.ESC heart failure · 2025Review
- Incidence of Heart Failure in Asian American, Native Hawaiian, and Other Pacific Islander Populations.Journal of the American College of Cardiology · 2025Article
- Worsening heart failure: progress, pitfalls, and perspectives.Heart failure reviews · 2025Review
- Finerenone and Outpatient Worsening Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial.JAMA cardiology · 2025Article
- Machine learning-based model for worsening heart failure risk in Chinese chronic heart failure patients.ESC heart failure · 2025Article
- Outpatient care changes and associated mortality among Veterans with heart failure during the COVID-19 pandemic.PloS one · 2025Article
- Artificial Intelligence in Cardiovascular Clinical Trials.Journal of the American College of Cardiology · 2024Review
- Applying natural language processing to identify emergency department and observation encounters for worsening heart failure.ESC heart failure · 2024Article
- Sex-Based Differences in the Epidemiology, Clinical Characteristics, and Outcomes Associated with Worsening Heart Failure Events in a Learning Health System.Journal of cardiac failure · 2024Article
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Authors and funding
18 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThere is growing interest to disentangle worsening heart failure (WHF) from location of care and move away from hospitalization as a surrogate for acuity.
objectivesThe purpose of this study was to describe the incidence of WHF events across the care continuum from ambulatory encounters to hospitalizations.
methodsWe studied calendar year cohorts of adults with diagnosed heart failure (HF) from 2010-2019 within a large, integrated health care delivery system. Electronic health record (EHR) data were accessed for outpatient encounters, emergency department (ED) visits/observation stays, and hospitalizations. WHF was defined as ≥1 symptom, ≥2 objective findings including ≥1 sign, and ≥1 change in HF-related therapy. Symptoms and signs were ascertained using natural language processing.
resultsWe identified 103,138 eligible individuals with mean age 73.6 ± 13.7 years, 47.5% women, and mean left ventricular ejection fraction of 51.4% ± 13.7%. There were 1,136,750 unique encounters including 743,039 (65.4%) outpatient encounters, 224,670 (19.8%) ED visits/observation stays, and 169,041 (14.9%) hospitalizations. A total of 126,008 WHF episodes were identified, including 34,758 (27.6%) outpatient encounters, 28,301 (22.5%) ED visits/observation stays, and 62,949 (50.0%) hospitalizations. The annual incidence (events per 100 person-years) of WHF increased from 25 to 33 during the study period primarily caused by outpatient encounters (7 to 10) and ED visits/observation stays (4 to 7). The 30-day rate of hospitalizations for WHF ranged from 8.2% for outpatient encounters to 12.4% for hospitalizations.
conclusionsED visits/observation stays and outpatient encounters account for approximately one-half of WHF events, are driving the underlying growth in HF morbidity, and portend a poor short-term prognosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.