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Specialist intervention is associated with improved patient outcomes in patients with decompensated heart failure: evaluation of the impact of a multidisciplinary inpatient heart failure team

View Article: PubMed Central - PubMed

ABSTRACT

Objective: The study aimed to evaluate the impact of a multidisciplinary inpatient heart failure team (HFT) on treatment, hospital readmissions and mortality of patients with decompensated heart failure (HF).

Methods: A retrospective service evaluation was undertaken in a UK tertiary centre university hospital comparing 196 patients admitted with HF in the 6 months prior to the introduction of the HFT (pre-HFT) with all 211 patients seen by the HFT (post-HFT) during its first operational year.

Results: There were no significant differences in patient baseline characteristics between the groups. Inpatient mortality (22% pre-HFT vs 6% post-HFT; p<0.0001) and 1-year mortality (43% pre-HFT vs 27% post-HFT; p=0.001) were significantly lower in the post-HFT cohort. Post-HFT patients were significantly more likely to be discharged on loop diuretics (84% vs 98%; p=<0.0001), ACE inhibitors (65% vs 76%; p=0.02), ACE inhibitors and/or angiotensin receptor blockers (83% vs 91%; p=0.02), and mineralocorticoid receptor antagonists (44% vs 68%; p<0.0001) pre-HFT versus post-HFT, respectively. There was no difference in discharge prescription rates of beta-blockers (59% pre-HFT vs 63% post-HFT; p=0.45).

Results: The mean length of stay (17±19 days pre-HFT vs 19±18 days post-HFT; p=0.06), 1-year all-cause readmission rates (46% pre-HFT vs 47% post-HFT; p=0.82) and HF readmission rates (28% pre-HFT vs 20% post-HFT; p=0.09) were not different between the groups.

Conclusions: The introduction of a specialist inpatient HFT was associated with improved patient outcome. Inpatient and 1-year mortality were significantly reduced. Improved use of evidence-based drug therapies, more intensive diuretic use and multidisciplinary care may contribute to these differences in outcome.

No MeSH data available.


Related in: MedlinePlus

Mortality, 1-year all-cause and HF readmission and specialist follow-up rates in the pre-HFT and post-HFT cohorts. *Denotes statistically significant difference between pre-HFT and post-HFT. HFT, heart failure team.
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Figure 2: Mortality, 1-year all-cause and HF readmission and specialist follow-up rates in the pre-HFT and post-HFT cohorts. *Denotes statistically significant difference between pre-HFT and post-HFT. HFT, heart failure team.

Mentions: The mean length of stay was similar at 17±19 days pre-HFT and 19±18 days post-HFT (p=0.06) (figure 2). Of those patients successfully discharged from hospital in the pre-HFT cohort, 67 out of 145 patients (46%) were readmitted to the hospital as an emergency in the subsequent year, whereas 93 out of 196 (47%) were admitted from the post-HFT cohort (p=0.82). Of the pre-HFT readmissions, 40 out of 144 (28%) were due to HF compared with 39 out of 196 (20%) of the post-HFT readmissions (p=0.09).


Specialist intervention is associated with improved patient outcomes in patients with decompensated heart failure: evaluation of the impact of a multidisciplinary inpatient heart failure team
Mortality, 1-year all-cause and HF readmission and specialist follow-up rates in the pre-HFT and post-HFT cohorts. *Denotes statistically significant difference between pre-HFT and post-HFT. HFT, heart failure team.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384462&req=5

Figure 2: Mortality, 1-year all-cause and HF readmission and specialist follow-up rates in the pre-HFT and post-HFT cohorts. *Denotes statistically significant difference between pre-HFT and post-HFT. HFT, heart failure team.
Mentions: The mean length of stay was similar at 17±19 days pre-HFT and 19±18 days post-HFT (p=0.06) (figure 2). Of those patients successfully discharged from hospital in the pre-HFT cohort, 67 out of 145 patients (46%) were readmitted to the hospital as an emergency in the subsequent year, whereas 93 out of 196 (47%) were admitted from the post-HFT cohort (p=0.82). Of the pre-HFT readmissions, 40 out of 144 (28%) were due to HF compared with 39 out of 196 (20%) of the post-HFT readmissions (p=0.09).

View Article: PubMed Central - PubMed

ABSTRACT

Objective: The study aimed to evaluate the impact of a multidisciplinary inpatient heart failure team (HFT) on treatment, hospital readmissions and mortality of patients with decompensated heart failure (HF).

Methods: A retrospective service evaluation was undertaken in a UK tertiary centre university hospital comparing 196 patients admitted with HF in the 6 months prior to the introduction of the HFT (pre-HFT) with all 211 patients seen by the HFT (post-HFT) during its first operational year.

Results: There were no significant differences in patient baseline characteristics between the groups. Inpatient mortality (22% pre-HFT vs 6% post-HFT; p<0.0001) and 1-year mortality (43% pre-HFT vs 27% post-HFT; p=0.001) were significantly lower in the post-HFT cohort. Post-HFT patients were significantly more likely to be discharged on loop diuretics (84% vs 98%; p=<0.0001), ACE inhibitors (65% vs 76%; p=0.02), ACE inhibitors and/or angiotensin receptor blockers (83% vs 91%; p=0.02), and mineralocorticoid receptor antagonists (44% vs 68%; p<0.0001) pre-HFT versus post-HFT, respectively. There was no difference in discharge prescription rates of beta-blockers (59% pre-HFT vs 63% post-HFT; p=0.45).

Results: The mean length of stay (17±19 days pre-HFT vs 19±18 days post-HFT; p=0.06), 1-year all-cause readmission rates (46% pre-HFT vs 47% post-HFT; p=0.82) and HF readmission rates (28% pre-HFT vs 20% post-HFT; p=0.09) were not different between the groups.

Conclusions: The introduction of a specialist inpatient HFT was associated with improved patient outcome. Inpatient and 1-year mortality were significantly reduced. Improved use of evidence-based drug therapies, more intensive diuretic use and multidisciplinary care may contribute to these differences in outcome.

No MeSH data available.


Related in: MedlinePlus