Long-term prognosis of patients hospitalized with acute heart failure

Česká verzia

Authors: K. Zeman ¹; L. Pohludková ¹; L. Nováková ¹; L. Dušek ²; S. Littnerová ²; R. Miklík ³; J. Pařenica ³; J. Špinar ³; J. Jarkovský ²
Authors place of work: Interní oddělení Nemocnice ve Frýdku-Místku, p. o., Primář: MUDr. Petr Vítek, PhD. ¹; Institut biostatistiky a analýz, MU Brno, Ředitel: doc. RNDr. Ladislav Dušek, PhD. ²; Interní kardiologická klinika Lékařské fakulty MU a FN Brno, Přednosta: prof. MUDr. Jindřich Špinar, CSc. ³
Published in the journal: Prakt. Lék. 2012; 92(8): 465-469
Category: Of different specialties

Summary

Aim:
Acute heart failure (AHF) is a syndrome with poor prognosis and rising prevalence. The aim of our work is to describe the characteristics, treatment and prognosis of patients hospitalized with the diagnosis of AHF in the regional hospital and to highlight the benefits of increased supervision and education of these patients early after a hospital discharge.

Patients and Methods:
752 patients were hospitalized because of AHF in the Hospital Frydek-Mistek from 1/2007 to 5/2009 (29 months). A part of them was re-admitted for the same diagnosis during the period for two to six times. Data were collected by physicians using the National Register of Acute Heart Failure (AHEAD); a systematic classification of patients with AHF was based on the Czech Society of Cardiology´s Recommendation for diagnosis and treatment of acute heart failure (the 2005 version). The statistical analysis was performed in collaboration with the Institute of Biostatistics and Analyses, Masaryk University, Brno.

Results:
AHF comprises about 9% of all hospitalizations at the Internal Department of the hospital. It represents about 245 hospitalizations per 100,000 inhabitants/year. Median duration of hospitalization for AHF was 6.5 days. Most of the patients had more comorbidities and were elderly; median of age was 77.5 years. A total of 30% patients were not self-sufficient at discharge, 5% of them required hospitalization in hospices, 8.6% required translation to cardiocentre, 70% of patients were discharged home. 18% of patients were re-admitted for AHF at least once in the period. In-hospital mortality was 14.4, total thirty-day mortality was 16.8%. Overall one-year survival rate reached 70.3% and two-year survival rate 54.9%.

Conclusion:
The data presented above confirm the poor prognosis of patients hospitalized with AHF syndrome. The nature of the disease makes it necessary to understand and manage therapeutic measures by patients and their close relatives. Our goal is to improve the prognosis and quality of life of patients and reduce the need for re-hospitalizations.

We consider establishing comprehensive outpatient nursing programs for patients with heart failure as an important step that significantly improves care for the patients and also reduces costs for the repeated AHF treatment.

Key words:
acute heart failure, prognosis, specialized ambulatory program, AHEAD

Zdroje

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