title: Acute heart failure admissions in New South Wales and the Australian Capital Territory: the NSW HF Snapshot Study.
abstract: OBJECTIVE
  The primary aim of the NSW Heart Failure (HF) Snapshot was to obtain a representative cross-sectional view of patients with acute HF and their management in New South Wales and Australian Capital Territory hospitals.
  
  
  METHODS
  A prospective audit of consecutive patients admitted to 24 participating hospitals in NSW and the ACT with a diagnosis of acute HF was conducted from 8 July 2013 to 8 August 2013.
  
  
  RESULTS
  A total of 811 participants were recruited (mean age, 77 ± 13 years; 58% were men; 42% had a left ventricular ejection fraction ≥ 50%). The median Charlson Comorbidity Index score was 3, with ischaemic heart disease (56%), renal disease (55%), diabetes (38%) and chronic lung disease (32%) the most frequent comorbidities; 71% of patients were assessed as frail. Intercurrent infection (22%), non-adherence to prescribed medication (5%) or to dietary or fluid restrictions (16%), and atrial fibrillation/flutter (15%) were the most commonly identified precipitants of HF. Initial treatment included intravenous diuretics (81%), oxygen therapy (87%), and bimodal positive airways pressure or continuous positive airways pressure ventilation (17%). During the index admission, 6% of patients died. The median length of stay in hospital was 6 days, but ranged between 3 and 12 days at different hospitals. Just over half the patients (59%) were referred to a multidisciplinary HF service. Discharge medications included angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (59%), β-blockers (66%) and loop diuretics (88%).
  
  
  CONCLUSIONS
  Patients admitted to hospital with acute HF in NSW and the ACT were generally elderly and frail, with multiple comorbidities. Evidence-based therapies were underused, and there was substantial interhospital variation in the length of stay. We anticipate that the results of the HF Snapshot will inform the development of strategies for improving the uptake of evidence-based therapies, and hence outcomes, for HF patients.
authors: Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW phillip.newton@uts.edu.au.
authors: Phillip J
authors: PJ
authors: Newton
authors: Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW.
authors: Patricia M
authors: PM
authors: Davidson
authors: Curtin University, Perth, WA.
authors: Christopher M
authors: CM
authors: Reid
authors: Monash Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, VIC.
authors: Henry
authors: H
authors: Krum
authors: St Vincent's Hospital, Sydney, NSW.
authors: Christopher
authors: C
authors: Hayward
authors: Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Sydney, NSW.
authors: David W
authors: DW
authors: Sibbritt
authors: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.
authors: Emily
authors: E
authors: Banks
authors: St Vincent's Hospital, Sydney, NSW.
authors: Peter S
authors: PS
authors: MacDonald
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation; D020958:Australian Capital Territory; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D016330:Frail Elderly; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D008297:Male; D008485:Medical Audit; D055118:Medication Adherence; D008875:Middle Aged; D009517:New South Wales; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D004232:Diuretics