ISSN 1671-5411 CN 11-5329/R
Marie-Louise Edvinsson, Albin Stenberg, Karin Astrom-Olsson. Improved outcome with standardized plan for clinical management of acute decompensated chronic heart failure. J Geriatr Cardiol 2019; 16(1): 12-18. doi: 10.11909/j.issn.1671-5411.2019.01.002
Citation: Marie-Louise Edvinsson, Albin Stenberg, Karin Astrom-Olsson. Improved outcome with standardized plan for clinical management of acute decompensated chronic heart failure. J Geriatr Cardiol 2019; 16(1): 12-18. doi: 10.11909/j.issn.1671-5411.2019.01.002

Improved outcome with standardized plan for clinical management of acute decompensated chronic heart failure

doi: 10.11909/j.issn.1671-5411.2019.01.002
Funds:

This work was supported by the Swedish Heart-Lung Foundation.

  • Received Date: 2018-10-22
  • Rev Recd Date: 2019-01-03
  • Publish Date: 2019-01-28
  • Background Our overall goal is to improve clinical care for inpatients with chronic heart failure (CHF). A retrospective assessment of CHF patients admitted to our hospital over the past decade (2005 vs. 2014) indicated a need for better strategies to evaluate clinical treatment, implement best practices and achieve optimal patient outcome. To that purpose, we developed a standardized plan to improve in-hospital treatment of acute decompensated CHF patients. Methods & Results Retrospective chart reviews were conducted to compare three cohorts of CHF patients admitted to the University Hospital of Lund at different time points over a 12-year period: 2005 (365 patients), 2014 (172 patients) and 2017–2018 (57 patients). Little improvement was seen between 2005 and 2014 with respect to one-year mortality (35% vs. 34%) and adequate treatment with recommended medications, e.g., use of renin-angiotensin system blockers (45% vs. 51%). A standardized treatment plan was devised to improve outcomes. A third cohort, treated under the plan (2017–2018), was compared with the 2014 cohort. One-year mortality (18% vs. 34%) and 30-day readmission (5% vs. 30%) were dramatically decreased, and adherence to medication guidelines was achieved. Key elements of the plan included well-defined treatment procedures, enhanced communication and teamwork, education, adequate time for treatment (5 days) and post-discharge follow-up as necessary. Natriuretic peptide (NT-proBNP) levels were useful for assessing patient status, prognosis and response to treatment. Conclusions Development of a standard plan for clinical management of acute decompensated CHF patients resulted in significant improvements in patient outcome, as reflected in decreased rates of 30-day readmission and one-year mortality.
  • loading
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (802) PDF downloads(627) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return