1. Hospital-based heart failure care program in a cohort of elderly spanish patients: what is changing?
J A. Satué, S. Gonzalo Pascua, J. Marrero Francés, J C. Belinchón Paraíso, A. Pérez Martín, L. Horrillo Sánchez, A. Sanmartín Prado, P. Talavera Calle*, A. Zapatero Gaviria.
Internal Medicine and *Cardiology, University Hospital of Fuenlabrada, Fuenlabrada, Madrid, Spain.
Table 1
Patients included N(%)
Standard Care (n=74)
Heart failure care program (n=48) p
Sex, women
53 (70%)
36(75%)
0,8351
Age, mean
80.9
78.3
0,3222
Registered EF
47 (63%)
40 (84%)
0,0238
Reduced EF
11 (23%)
8 (20%)
0,8029
Valvular etiology
18 (38%)
30 (62%)
0,0001
Atrial Fibrillation
39 (49%)
27 (56%)
0,7144
Cause of decompensation : Arrythmia
7 (10%)
12(25%)
0,0386
Aldosterone antagonists
14(16%)
16(33%)
0,0867
One year survival
56(77%)
44 (91.7%)
0.0301
Objectives: The aim of this study is to compare clinical profile and changes in management and prognosis of Heart Failure (HF) patients after starting a Hospital Based HF Care Program.
Patients and methods: All consecutive patients admitted into our Internal Medicine Department with HF and included into our Hospital HF Care Program from june 2011 to march 2012 were prospectively recruited. Demographic data, cardiovascular risk factors, clinical, biochemical and echocardiography findings, and treatments at discharge were registered in a specific database integrated in our electronic medical record system. Data were compared with a previous cohort of 74 patients admitted in 2007 into our department with a diagnosis of HF and managed with standard care after discharge.
Our Hospital HF Care Program starts during index HF admission, and includes educational measures for patients and caregivers, scheduled specific hospital consults in follow up, and telephonic access after discharge, to optimize treatment and reduce readmission rates.
Results: 48 patients were included to the Hospital Based HF Care Program; main differential characteristics of previous standard care vs Hospital Based HF Care program patients are listed in Table 1.
Conclussions: Patients included in our Hospital Based Heart Failure Care Program were slightly younger than previous standard care cohort; they were also usually women with Preserved LVEF, in Atrial Fibrillation; increase in EF registration, valvular etiology, and arrhythmia as main cause of decompensation are the most reliable differences between the two cohorts. Among therapeutics, Aldosterone antagonists and Betablockers had an increase in use, but not reaching statistical significance. Unadjusted survival rate at 12 months was significantly higher among HF care program patients than previous cohort.