title: [Characteristics of the population hospitalized for advanced and terminal heart failure and experiences in palliative caring in the Intensive Care Unit of cardiology].
abstract: OBJECTIVE
  Advanced heart failure incidence is in progression. Palliative care access remains difficult due to its unpredictable course. The aim of this study was to describe the characteristics of patients admitted in Cardiology Intensive Care Unit for advanced heart failure who received palliative care and compare them to the whole population of acute heart failure hospitalized in the same period.
  
  
  METHODS
  The patients hospitalized for acute heart failure were retrospectively included from 2009 to 2013. We identified among them those who received palliative care. Specific caring was decided in pluridisciplinary meeting.
  
  
  RESULTS
  On 940 patients included, 42 patients (4.5%) receive palliative care. Ischemic heart disease was the main etiology (n=19; 45.2%). Right ventricular dysfunction (n=34; 80.9%) was associated with supra-ventricular arrhythmia (n=28; 66.7%). Twenty-eight patients (57.1%) have died in hospital, 9 (21.4%) were referred to a palliative care unit and 8 (19.1%) was discharged or referred to a rehabilitation center. Time between inclusion and death was 6 days on average. Intra-hospital mortality in control group was 6.8%.
  
  
  CONCLUSIONS
  Palliative care in cardiology is uncommon and has often been too late because of its poor adaptability to advanced heart failure. It is, as consequence, necessary to identify the prognostic factors of these patients in order to propose a personalized care and to adjust the intensity of care ahead of the terminal evolution of heart failure.
authors.affiliation: Service de réanimation médicale, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. Electronic address: alexandre.bedet@hmn.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Bedet
authors.affiliation: Service de cardiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Garçon
authors.affiliation: Service de cardiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Boulogne
authors.affiliation: Soins palliatifs, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Richard
authors.affiliation: Soins palliatifs, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Opatowski
authors.affiliation: Service de cardiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Moubarak
authors.affiliation: Service et département d'information médical, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Rejasse
authors.affiliation: Service de cardiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Cador
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003299:Cooperative Behavior; D003325:Coronary Care Units; D018450:Disease Progression; D005260:Female; D005602:France; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D010166:Palliative Care; D010360:Patient Transfer; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013727:Terminal Care
keywords: Atrial fibrillation; Dysfonction cardiaque droite; Fibrillation auriculaire; Heart failure; Insuffisance cardiaque; Palliative care; Quality of life; Qualité de vie; Right ventricular dysfunction; Soins palliatifs