Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Clinical Characteristics and Outcomes of Heart Failure Patients With Long-Term Care Insurance ― Insights From the Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―
Kensuke TakabayashiKotaro IwatsuTsutomu IkedaYuko MorikamiTahei IchinoheTakashi YamamotoKotoe TakenakaHiroyuki TakenakaHiroyuki MuranakaRyoko FujitaMiyuki OkudaOsamu NakajimaHitoshi KoitoYuka TerasakiTetsuhisa KitamuraShouji KitaguchiRyuji Nohara
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Supplementary material

2020 Volume 84 Issue 9 Pages 1528-1535

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Abstract

Background:In Japan, the long-term care insurance (LTCI) system has an important role in helping elderly people, but there have been no clinical studies that have examined the relationship between the LTCI and prognosis for patients with acute heart failure (HF).

Methods and Results:This registry was a prospective multicenter cohort, 1,253 patients were enrolled and 965 patients with acute HF aged ≥65 years were comprised the study group. The composite endpoint included all-cause death and hospitalization for HF after discharge. We divided the patients into 4 groups: (i) patients without LTCI, (ii) patients requiring support level 1 or 2, (iii) patients with care level 1 or 2, and (iv) patients with care levels 3–5. The Kaplan-Meier analysis identified a lower rate of the composite endpoint in group (i) than in the other groups. After adjusting for potentially confounding effects using a Cox proportional regression model, the hazard ratio (HR) of the composite endpoint increased significantly in groups (iii) and (iv) (adjusted HR, 1.62; 95% confidence interval [CI], 1.22–1.98 and adjusted HR, 1.62; 95% CI, 1.23–2.14, respectively) when compared with group (i). However, there was no significant difference between groups (i) and (ii).

Conclusions:The level of LTCI was associated with a higher risk of the composite endpoint after discharge in acute HF patients.

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© 2020 THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
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