© 2002 European Society of Cardiology
Hospitalization for congestive heart failure: is it still a cardiology business?
a Cardiology Institute of the University Hospital S. Orsola-Malpighi Via Massarenti n. 9, 40100 Bologna, Italy
b Medical Management Staff of the University Hospital S. Orsola-Malpighi Bologna, Italy
* Corresponding author. Tel.: +39-051-6364-526; fax: +39-051-3448-59. E-mail address: bibcard{at}almadns.unibo.it
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Abstract |
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Background: Hospital management of CHF and predictors of hospital mortality remain unclear.
Methods: To address these issues, we analyzed the hospital admissions for CHF during 1996 in a large university hospital. Patients discharged with the principal diagnosis of CHF were considered eligible for the study.
Results: Among the 1511 patients (3% of all discharges) who satisfied the inclusion criteria, 75% were treated in general medicine departments (GMD) and 22% in cardiology units (CU). Patients admitted to GMD were older than those treated in CU (79±10 vs. 68±15 years, P<0.001), included a higher proportion of females (56% vs. 37%, P<0.001), and presented a higher rate of hospital mortality (13% vs. 4%, P<0.001). The overall mean length of stay was 11±9 days. At multivariate analysis, length of stay was not associated with the department (i.e. GMD/CU) (P=0.273).
Conclusions: CHF is a common lethal condition often requiring treatment in GMD. Length of stay appears to depend more on patients' characteristics than on differences in practice between GMD and CU. Patients admitted to GMD present higher rates of comorbidity and hospital mortality. Strategies are urgently needed to improve hospital management of CHF.
Key Words: CAD, coronary artery disease • CCU, coronary care units • CHF, congestive heart failure • CU, cardiology units • ED, emergency departments • GMD, general medicine departments • ICU, intensive care units
Received December 15, 2000; Revised June 7, 2001; Accepted September 7, 2001