Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study
Objective: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. Methods: This retrospective observational study enrolled all patients discharged in 2012 a...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-06-01
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| Series: | Revista Portuguesa de Cardiologia |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255117303372 |
| _version_ | 1818277605998067712 |
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| author | Irene Marques Sara Abreu Manuela V. Bertão Betânia Ferreira Raquel Lopes Ramos Juliana Lopes Sandra Nunes Denisa Mendonça Laetitia Teixeira |
| author_facet | Irene Marques Sara Abreu Manuela V. Bertão Betânia Ferreira Raquel Lopes Ramos Juliana Lopes Sandra Nunes Denisa Mendonça Laetitia Teixeira |
| author_sort | Irene Marques |
| collection | DOAJ |
| description | Objective: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. Methods: This retrospective observational study enrolled all patients discharged in 2012 after hospitalization for acute HF. Discharge summaries, clinical records and telephone interviews were analysed. The data reports to the year before implementation of a heart failure clinic. Results: Four hundred and twenty-nine patients were enrolled, with a mean age of 79 years, 62.5% female. The most prevalent comorbidity and etiology was hypertension (86.7%) and the most frequent decompensation trigger was infection. HF with preserved ejection fraction (HFpEF) was present in 70.5%. In-hospital mortality was 7.9%. At discharge more than half of the patients were prescribed beta-blockers (52.8%) and angiotensin-converting enzyme inhibitors (52%). Women presented a significantly higher proportion of HFpEF than men (75.3% vs. 62.7%, p=0.01). Patients with diabetes and those with ischemic etiology had significantly higher proportions of HF with reduced ejection fraction (HFrEF) (34.8% vs. 24.3% in non-diabetic patients, p=0.027, and 56.2% vs. 15.6% for other etiologies, p<0.001). The HFrEF group were more frequently discharged under beta-blockers and spironolactone (75.2% vs. 46.4% in the HFpEF group, p<0.001 and 31.2% vs. 12.6% in the HFpEF group, p<0.001, respectively). Mortality was 34.3% and rehospitalization for HF was 30.5% in one-year follow-up. Conclusions: The population characterized is an elderly one, mainly female and with HFpEF. Nearly a third of patients died and/or were rehospitalized in the year following discharge. Resumo: Objetivo: Caracterizar os doentes hospitalizados por Insuficiência Cardíaca (IC) aguda num Serviço de Medicina Interna, a mortalidade e rehospitalização por IC no primeiro ano. Métodos: Estudo retrospetivo observacional incluindo todos os doentes com alta em 2012 de hospitalização por IC aguda, com base em Notas de Alta, registos clínicos e entrevistas telefónicas. Reporta-se ao ano prévio à implementação de uma clínica de IC. Resultados: Identificaram-se 429 doentes, com idade média de 79 anos; 62,5% eram mulheres. A comorbilidade e etiologia mais prevalente foi a hipertensão arterial (86,7%) e o fator precipitante mais frequente da descompensação foi a infeção. Verificou-se Fração de Ejeção Preservada (FEp) em 70,5% dos doentes. A mortalidade intra-hospitalar foi 7,9%. À alta, a maioria dos doentes tinha prescrição de betabloqueadores (BB) (52,8%) e inibidores de enzima de conversão da angiotensina (52%). As mulheres apresentaram mais frequentemente FEp do que os homens (75,3% versus 62,7%, p=0,01). Os doentes diabéticos e os com etiologia isquémica apresentaram mais frequentemente Fração de Ejeção Reduzida (FEr) (34,8% versus 24,3% em não diabéticos, p=0,027 e 56,2% versus 15,6% com outras etiologias, p<0,001, respetivamente). No grupo com FEr, os BB e a espironolactona foram mais prescritos à alta (75,2% versus 46,4% no grupo com FEp, p<0,001 e 31,2% versus 12,6% no grupo com FEp, p<0,001, respetivamente). No primeiro ano, a taxa de mortalidade foi 34,3% e de rehospitalização por IC 30,5%. Conclusões: A população estudada é idosa, predominantemente feminina e apresenta IC com FEp. Um terço morreu e/ou foi reinternada no ano seguinte. Keywords: Heart failure, Mortality, Hospitalization, Patient rehospitalization, Hospital readmission, Palavras-chave: Insuficiência cardíaca, Mortalidade, Hospitalização, Reinternamento, Rehospitalização |
| first_indexed | 2024-12-12T23:04:12Z |
| format | Article |
| id | doaj.art-a1fb6762074f442eab36b3795f4bef98 |
| institution | Directory Open Access Journal |
| issn | 0870-2551 |
| language | English |
| last_indexed | 2024-12-12T23:04:12Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Portuguesa de Cardiologia |
| spelling | doaj.art-a1fb6762074f442eab36b3795f4bef982022-12-22T00:08:44ZengElsevierRevista Portuguesa de Cardiologia0870-25512017-06-01366431438Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC studyIrene Marques0Sara Abreu1Manuela V. Bertão2Betânia Ferreira3Raquel Lopes Ramos4Juliana Lopes5Sandra Nunes6Denisa Mendonça7Laetitia Teixeira8Department of Internal Medicine, Centro Hospitalar do Porto, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; Corresponding author.Department of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Internal Medicine, Centro Hospitalar do Porto, Porto, PortugalDepartment of Population Studies, Instituto de Ciências Biomédicas de Abel Salazar, EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, PortugalDepartment of Population Studies, Instituto de Ciências Biomédicas de Abel Salazar, CINTESIS/ICBAS-UP, EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, PortugalObjective: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. Methods: This retrospective observational study enrolled all patients discharged in 2012 after hospitalization for acute HF. Discharge summaries, clinical records and telephone interviews were analysed. The data reports to the year before implementation of a heart failure clinic. Results: Four hundred and twenty-nine patients were enrolled, with a mean age of 79 years, 62.5% female. The most prevalent comorbidity and etiology was hypertension (86.7%) and the most frequent decompensation trigger was infection. HF with preserved ejection fraction (HFpEF) was present in 70.5%. In-hospital mortality was 7.9%. At discharge more than half of the patients were prescribed beta-blockers (52.8%) and angiotensin-converting enzyme inhibitors (52%). Women presented a significantly higher proportion of HFpEF than men (75.3% vs. 62.7%, p=0.01). Patients with diabetes and those with ischemic etiology had significantly higher proportions of HF with reduced ejection fraction (HFrEF) (34.8% vs. 24.3% in non-diabetic patients, p=0.027, and 56.2% vs. 15.6% for other etiologies, p<0.001). The HFrEF group were more frequently discharged under beta-blockers and spironolactone (75.2% vs. 46.4% in the HFpEF group, p<0.001 and 31.2% vs. 12.6% in the HFpEF group, p<0.001, respectively). Mortality was 34.3% and rehospitalization for HF was 30.5% in one-year follow-up. Conclusions: The population characterized is an elderly one, mainly female and with HFpEF. Nearly a third of patients died and/or were rehospitalized in the year following discharge. Resumo: Objetivo: Caracterizar os doentes hospitalizados por Insuficiência Cardíaca (IC) aguda num Serviço de Medicina Interna, a mortalidade e rehospitalização por IC no primeiro ano. Métodos: Estudo retrospetivo observacional incluindo todos os doentes com alta em 2012 de hospitalização por IC aguda, com base em Notas de Alta, registos clínicos e entrevistas telefónicas. Reporta-se ao ano prévio à implementação de uma clínica de IC. Resultados: Identificaram-se 429 doentes, com idade média de 79 anos; 62,5% eram mulheres. A comorbilidade e etiologia mais prevalente foi a hipertensão arterial (86,7%) e o fator precipitante mais frequente da descompensação foi a infeção. Verificou-se Fração de Ejeção Preservada (FEp) em 70,5% dos doentes. A mortalidade intra-hospitalar foi 7,9%. À alta, a maioria dos doentes tinha prescrição de betabloqueadores (BB) (52,8%) e inibidores de enzima de conversão da angiotensina (52%). As mulheres apresentaram mais frequentemente FEp do que os homens (75,3% versus 62,7%, p=0,01). Os doentes diabéticos e os com etiologia isquémica apresentaram mais frequentemente Fração de Ejeção Reduzida (FEr) (34,8% versus 24,3% em não diabéticos, p=0,027 e 56,2% versus 15,6% com outras etiologias, p<0,001, respetivamente). No grupo com FEr, os BB e a espironolactona foram mais prescritos à alta (75,2% versus 46,4% no grupo com FEp, p<0,001 e 31,2% versus 12,6% no grupo com FEp, p<0,001, respetivamente). No primeiro ano, a taxa de mortalidade foi 34,3% e de rehospitalização por IC 30,5%. Conclusões: A população estudada é idosa, predominantemente feminina e apresenta IC com FEp. Um terço morreu e/ou foi reinternada no ano seguinte. Keywords: Heart failure, Mortality, Hospitalization, Patient rehospitalization, Hospital readmission, Palavras-chave: Insuficiência cardíaca, Mortalidade, Hospitalização, Reinternamento, Rehospitalizaçãohttp://www.sciencedirect.com/science/article/pii/S0870255117303372 |
| spellingShingle | Irene Marques Sara Abreu Manuela V. Bertão Betânia Ferreira Raquel Lopes Ramos Juliana Lopes Sandra Nunes Denisa Mendonça Laetitia Teixeira Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study Revista Portuguesa de Cardiologia |
| title | Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study |
| title_full | Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study |
| title_fullStr | Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study |
| title_full_unstemmed | Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study |
| title_short | Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study |
| title_sort | characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic the precic study |
| url | http://www.sciencedirect.com/science/article/pii/S0870255117303372 |
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