[Reduction in heart failure hospitalization rate during the first year of follow-up at a multidisciplinary unit].
OBJECTIVE
Heart failure leads to frequent hospital readmissions. The aim of this study was to assess how receiving attention at our multidisciplinary unit influenced hospitalization for heart failure. We compared the number of admissions in the year preceding attendance with that in the first year of follow-up.


METHODS
In total, 366 patients were admitted between August 2001 and June 2003. Of these, 332 were still alive and could be assessed clinically 1 year later. The most common etiologies were ischemic heart disease in 60%, and dilated cardiomyopathy in 10%.


RESULTS
The number of admissions in the year preceding attendance was 246, while that during the first year of follow-up was 125, which corresponds to a statistically significant reduction of 49% (P<.001). The reduction was even greater (54%, P<.001), when only patients who were hospitalized more than once in the preceding year were analyzed. Moreover, in addition to the improvements noted during follow-up in patients' understanding of the disease and in several aspects of self-care, the increase in treatment use was also remarkable: beta-blocker use increased from 53% to 70%, spironolactone use from 20% to 30%, and statin use from 36% to 58%.


CONCLUSIONS
The number of hospital admissions for heart failure among patients who received attention at our multidisciplinary unit was significantly less in the first year of follow-up than in the year preceding attendance. This reduction was probably due to educational and pharmacologic interventions and to closer follow-up.
Lupón
Josep
J
Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. jlupon@ns.hugtip.scs.es
Parajón
Teresa
T
Urrutia
Agustín
A
González
Beatriz
B
Herreros
Juan
J
Altimir
Salvador
S
Coll
Ramon
R
Prats
Montserrat
M
Valle
Vicente
V
D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy*; D006757:Hospital Units; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors