Comparison of Characteristics and Outcomes in Patients With Acute Decompensated Heart Failure Admitted Under General Medicine and Cardiology Units.

Autor: Suo E; The Alfred Hospital, Melbourne, Vic, Australia., Driscoll A; Deakin University, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia., Dinh D; Monash University, Melbourne, Vic, Australia., Brennan A; Monash University, Melbourne, Vic, Australia., Kaye DM; The Alfred Hospital, Melbourne, Vic, Australia; Baker IDI Heart Diabetes Institute, Melbourne, Vic, Australia., Stub D; The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia; Baker IDI Heart Diabetes Institute, Melbourne, Vic, Australia., Lefkovits J; The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia; The Royal Melbourne Hospital, Melbourne, Vic, Australia., Reid CM; Monash University, Melbourne, Vic, Australia; Curtin University, Perth, WA, Australia., Hopper I; The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia. Electronic address: I.hopper@alfred.org.au.
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2024 Jul; Vol. 33 (7), pp. 983-989. Date of Electronic Publication: 2024 Mar 07.
DOI: 10.1016/j.hlc.2024.01.016
Abstrakt: Background: Acute decompensated heart failure (ADHF) is a leading cause of cardiovascular disease hospitalisations associated with significant morbidity and mortality. In hospitals, HF patients are typically managed by cardiology or physician teams, with differences in patient demographics and clinical outcomes. This study utilises contemporary HF registry data to compare patient characteristics and outcomes in those with ADHF admitted into General Medicine and Cardiology units.
Methods: The Victorian Cardiac Outcomes Registry was utilised to identify patients hospitalised with ADHF 30-day period in each of four consecutive years. We compared patient characteristics, pharmacological management and outpatient follow-up of patients admitted to General Medicine and Cardiology units. Primary outcome measures included in-hospital mortality, 30-day readmission, and 30-day mortality.
Results: Between 2014 and 2017, a total of 1,253 patients with ADHF admissions were registered, with 53% admitted in General Medicine units and 47% in Cardiology units. General Medicine patients were more likely to be older (82 vs 71 years; p<0.001), female (51% vs 34%; p<0.001), and have higher prevalence of comorbidities and preserved left ventricular function (p<0.001). There were no differences in primary outcome measures between General Medicine and Cardiology in terms of: in-hospital mortality (5.0% vs 3.9%; p=0.35), 30-day readmission (23.4% vs 23.6%; p=0.93), and 30-day mortality (10.0% vs 8.0%; p=0.21).
Conclusions: Hospitalised patients with HF continue to have high mortality and rehospitalisation rates. The choice of treatment by General Medicine or Cardiology units, based on the particular medical profile and individual needs of the patients, provides equivalent outcomes.
Competing Interests: Conflicts of Interest There are no conflicts of interest to disclose.
(Copyright © 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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