0440: Patient journey during hospitalization for acute heart failure in cardiology and geriatric departments of greater Paris university hospitals

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• 作者：Florent Laveau ; ⁽¹⁾ ; ^{florent.laveau@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Emmanuelle Berthelot⁽²⁾ ; Ariel Cohen⁽³⁾ ; Thibault Damy⁽⁴⁾ ; Denis Duboc⁽⁵⁾ ; Albert Hagege⁽⁶⁾ ; Guillaume Jondeau⁽⁷⁾ ; Damien Logeart⁽⁸⁾ ; Nicolas Mansencal⁽⁹⁾ ; Michel Komajda⁽⁹⁾
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：31
• 全文大小：229 K

文摘

Acute heart failure is a major health care problem and data on patient journey before/during/after hospitalization are limited. The aim of this study was to analyze patient journey from pre-hospital to discharge in acute heart failure in a multicentre observational study.

Methods and results

This observational study enrolled, one day per week, 257 patients with acute heart failure during five months (September 2014 – February 2015) in 14 departments of Paris (cardiology: 10; geriatrics: 4). Mean age was 77±15 years, 56% were male. First medical contact was an emergency department in 45% of cases, a general practitioner (GP) in 16%, and a cardiologist or a medical ambulance (13% each).

There was a single medical actor intervention before hospitalization in 78% of cases. 64% of patients were finally admitted through emergency departments. Previous history of heart failure was common (71%) and most frequent precipitating factors were arrhythmia (29%), infection (26%) and non-compliance to medical therapy (16%). Diabetes (28%), chronic pulmonary disease (19%) and cognitive disabilities (18%) were the most frequent co-morbidities. LVEF was preserved (>50%) in 32%. In-hospital stay was 13±12 days and 61% of patients stayed in an intensive cardiologic care unit (ICCU) for an average duration of 5.5±3.9 days. 64% of patients were directly discharged home and 21% were transferred to rehabilitation care units. In-hospital mortality was 2.4%.

Conclusion

Although heterogeneous patient admission for acute heart failure is made through emergency departments and GPs in the majority of cases, a stay in intensive care unit is observed in 61% of cases. Discharge from hospital is made at home in 2/3 of cases.

Therefore, actions to improve cooperation between professionals in the management of acute heart failure should target emergency departments and GPs.