0545: 3 years experiences of a heart failure management unit in Bordeaux: results and prognosis factors - 12/02/16
Résumé |
Background |
Heart failure is the leading cause of hospital admissions and economic burden. In accordance with guidelines, a dedicated heart failure unit has been created in Bordeaux (France) in May 2011.
Aim |
Evaluate the impact of a heart failure management unit with ambulatory sector on readmission rate and mortality; and identify prognosis parameters at diagnosis and 6 months after.
Methods |
Descriptive study of mortality and heart-failure-related readmission rates after a first admission for heart failure, from May 2011 to July 2014 (inclusion stopped in July 2013). Student’s test and Cox’s regression have been performed.
Results |
Since the creation of this unit, its activity has been growing by 30% in the first year and 10%, in the second. 421 patients with less than 40% left ventricular ejection fraction (LVEF) have been included; 181 had been treated before May 2011 while 240 were news patients treated during the study. Average age was 57±14 years old and average LVEF was 28%±7%. Therapeutics drugs cover was good compared to previous studies: 98% of patients has been treated by beta blockers, 94% by an antagonist of reninangiotensin-aldosteron system and 82% by an antagonist of mineralocorticoid receptor. Survival after 3 years of treatment was 87.5%. Re-admission rate was less than one readmission per patient and per year. No diagnosis parameter was a prognosis factor. But after 6 months of treatment, univariate analysis found significant prognosis factors of survival: dyspnea I-II, 6minutes walking test>300m, BNP<400ng/ml (p<0,001). In multivariate analysis only BNP<400ng/ml at 6 months was associated with survival (p=0,012).
Conclusion |
Heart failure management unit in Bordeaux is conformed to European guidelines. Ambulatory sector is a good solution to cope with increasing activity. The most predictive factor of survival in our unit experience was evaluation at 6 months after diagnosis (like BNP<400ng/ml).
Le texte complet de cet article est disponible en PDF.Vol 8 - N° 1
P. 33 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?