[Show abstract][Hide abstract] ABSTRACT: Heart failure is the leading cause of hospital admissions and an economic burden. In accordance with European guidelines, a dedicated heart failure unit was created in René Dubos Hospital (Pontoise, France) in 2002.
To evaluate the impact of an in-hospital heart failure management unit on heart failure prognosis.
We conducted a descriptive study of all-cause in-hospital mortality and heart failure related readmission rates in the year after the first admission for heart failure, from January 1997 to December 2007. The Chi(2) test, a trend test and linear regression were performed.
There were no significant differences in patient characteristics (age, sex, diabetes mellitus, left ventricular ejection fraction<45%) other than renal insufficiency, in patients admitted for heart failure from 1997 to 2007. After the creation of the heart failure unit, we observed a significant decrease in heart failure related readmission rate from 21.7% in 2002 to 15.6% in 2007 (p<0.0001), whereas there was no difference in this rate before the creation of the unit (34.3% in 1997 and in 2001; p=0.90). All-cause in-hospital mortality rate decreased from 9.3% in 1997 to 5.1% in 2007 (p<0.0001) and showed a tendency to decrease after the creation of the heart failure unit (p=0.06).
Heart failure related readmission rates in new patients in the year after the first admission for heart failure reduced dramatically after the creation of the heart failure unit. All-cause in-hospital mortality in heart failure patients decreased over the 10-year study period.
[Show abstract][Hide abstract] ABSTRACT: Background
Heart Failure (HF) is a frequent and severe disease. Overall prognosis of systolic HF is poor, and one-year survival rate is lower than most cancers. For that reason, HF units were progressively created in cardiology departments according to the European guidelines.
The aim of this study was to describe the evolution in all-cause in-hospital mortality in patients hospitalized for HF in the HF clinic created at René Dubos hospital (Pontoise, France).
We conducted a descriptive study of all-cause in-hospital mortality in a whole population of 4801 patients hospitalized for HF (range per year: 248-640 patients) from January 1997 to December 2007 in our HF clinic. Chi square, test for trend and linear regression were performed.
Our population consisted of 2331 men (48.6%) with a mean age per year ranging from 67.8 to 75.8 years, and a percentage of patients presenting with systolic HF (LVEF<45%) of 53.8%. There were no significant differences in terms of sex, diabetes mellitus or LVEF<45%, except for age and renal insufficiency. All-cause in-hospital mortality rate for patients hospitalized for HF appeared to be significantly decreasing during ten-year follow-up (p<0.0001) (see figure). Moreover we noticed that average length of hospital stay was decreasing during ten-year follow-up (p=0.027, -0.3 day per year).
Mortality in HF patients was confirmed to be decreasing during the last ten-year period, thereby confirming the impact of HF care management on HF prognosis.
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Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):23-23. DOI:10.1016/S1878-6480(10)70070-7