© 2002 European Society of Cardiology
Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care
a Heart Failure Clinic, Department of Internal Medicine Hospital de S. João, Porto, Portugal
b Unidade de Investigação e Desenvolvimento Cardiovascular Porto, Portugal
c Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
* Corresponding author. Tel. +351-22-5507597; fax: +351-22-5095618. E-mail address: anazev{at}med.up.pt
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Abstract |
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Ambulatory care by physicians especially devoted to the management of heart failure (HF) has been reported to have beneficial effects. The aim of this work was to assess the effect of outpatient management at a HF clinic, as compared with care by the usual assistant physician, on prognosis of HF patients. In this non-randomised study, we prospectively followed 339 patients after a hospitalisation index for HF, in order to compare prognosis between two groups of HF patients according to the ambulatory assistance setting: either a specific outpatient clinic (n=157) or the usual assistant physician (n=182). The outcomes assessed were all-cause death or cardiac-cause rehospitalisation during the first month after discharge and survival over the longer term. The risk of dying or being readmitted during the first month after discharge was significantly lower in patients followed at the HF clinic (adjusted odds ratio 0.23; 95% CI 0.12–0.46). Patients followed in the HF clinic also had an independent significantly lower hazard of dying during a longer-term follow up of average length 373 days (adjusted hazard ratio 0.52; 95% CI 0.34–0.81). The results support the fact that a multidisciplinary and permanently available medical staff might be of relevance in improving outcomes in HF patients.
Key Words: Heart failure • Outpatient management • Prognosis • Survival • Outcomes
Received March 30, 2001; Revised August 8, 2001; Accepted October 23, 2001
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