Please use this identifier to cite or link to this item: https://repositorio.usj.es/handle/123456789/255

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 SCOPUSID
Morton, Geraint
Antón-Solanas, Isabel ORCID RESEARCHERID SCOPUSID
Szymanski, Jane SCOPUSID
Greenwood, Elizabeth SCOPUSID
Grogono, Joanna ORCID RESEARCHERID SCOPUSID
Flett, Andrew S SCOPUSID
Cleland, John G F ORCID SCOPUSID
Cowburn, Peter J SCOPUSID
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

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