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Title: | 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 |
Authors: | Masters, Jayne
Morton, Geraint Antón-Solanas, Isabel Szymanski, Jane Greenwood, Elizabeth Grogono, Joanna Flett, Andrew S Cleland, John G F Cowburn, Peter J |
Keywords: | Insuficiencia cardíaca descompensada; Terapias farmacológicas; Atención multidisciplinaria especializada; Práctica clínica |
Issue Date: | 8-Mar-2017 |
Publisher: | BMJ Publishing Group |
Citation: | Masters J, Morton G, Anton I, et alSpecialist intervention is associated with improved patient outcomes in patients with decompensated heart failure: evaluation of the impact of a multidisciplinary inpatient heart failure teamOpen Heart 2017;4:e000547. doi: 10.1136/openhrt-2016-000547 |
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). 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. |
URI: | https://repositorio.usj.es/handle/123456789/255 |
ISSN: | 2053-3624 |
Appears in Collections: | Artículos de revistas |
Files in This Item:
File | Description | Size | Format | |
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e000547.full.pdf | 600,3 kB | Adobe PDF | View/Open |
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