Heart failure (HF) continues to be the most common reason for admission to a hospital for people over 65 years of age. Congestion, or fluid overload, is a primary clinical characteristic of patients presenting with HF.
In some patients, congestion can occur very rapidly but for most patients, congestion is a more generalized process that develops gradually, often leading to peripheral edema. Its identification and subsequent monitoring require affordable, objective and accurate tools to both reduce the cost burden this presents to the healthcare system and improve quality of life for these patients.
The clinical and cost burden of HF in the United States is enormous and projected to grow substantially as more people age into retirement and life expectancy increases. Today, there are approximately 6.5 million patients living with HF in the United States and 25 percent of them are classified as Class III (moderate-to-severe). HF incidence is nearly one-in-five after age 40, with prevalence increasing with age. Researchers predict that HF prevalence will increase approximately 46 percent in the next 15 years.
High cost of HF management Management of HF currently costs the U.S. healthcare system approximately $31 billion in hospitalization costs alone. Overall, the global economic cost in 2012 was estimated at $108 billion per annum.
HF is the most common discharge diagnosis among patients older than 65 years and the primary cause of readmission within 60 days. Costs are incurred from readmissions, as well as the mortality of the HF population at risk. Studies have found that approximately 50 percent of HF patients die within five years of diagnosis, but for those with a HF hospital admission, 22 percent die within one year. One in nine U.S. deaths has HF mentioned on the death certificate.
Fluid management Clearly, management of fluids in these patients is crucial. Accumulation of fluid in these patients is typically a gradual process. Techniques aimed at identifying large fluid accumulations over short periods of time are mostly ineffective. Many patients will not present until they have developed widespread peripheral edema. At this point, the need for medical intervention is obvious, but often too late.
A substantial number of patients with subclinical congestion will not be clinically diagnosed despite several symptoms, such as shortness of breath, fatigue, weakness, reduced ability to exercise, lack of appetite and more. Identification of this subclinical congestion at an earlier stage could allow for earlier changes in treatment and alter the progression of the condition.
