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Evaluation of heart failure management in a Military Hospital.
Guiraudet, O; Lambert de Crémeur, G; Bonnevie, L; Héno, P; Pelletier, C; Fraboulet, R; Schiano, P; Martin, A-C; Chenilleau, M-C; Delarbre, D; Chanudet, X.
Affiliation
  • Guiraudet O; Département de cardiologie, Hôpital d'Instruction des Armées Bégin, Saint-Mandé. olivierguiraudet@yahoo.fr
Arch Cardiovasc Dis ; 101(4): 235-41, 2008 Apr.
Article in En | MEDLINE | ID: mdl-18654098
PURPOSE: Evaluate heart failure management in a Military Hospital in 2005. METHODS: Retrospective audit of 46 case records of patients hospitalised with heart failure within the framework of an accreditation procedure. RESULTS: The left ventricular ejection fraction was evaluated in 85% of cases during the reference hospital stay. Systolic heart failure was detected in 63% of cases. At least one NT-proBNP assay was performed for each patient. A global assessment was systematically performed, except for the mini mental state examination in patients aged over 75 years who represented 80% of patients. Initial therapeutic education was provided for 50% of systolic heart failure patients. Prescription rates in systolic heart failure were 76% for angiotensin-converting enzyme inhibitors, 7% for angiotensin receptor antagonists; 84% for at least one medicinal product in the above 2 classes; 68% for beta-blockers and 32% for spironolactone. A hospital discharge report was available for 93% of the patients. Elective re-admissions to hospital for uptitration of treatment concerned 10% of systolic heart failure patients. Emergency hospital re-admissions after a cardiovascular event (usually decompensation), concerned 35% of patients, after an average duration of one year of follow-up. These latter re-admissions, often repeated, led to 4% of additional hospital deaths. The initial hospital mortality rate was 13%. CONCLUSION: Therapeutic patient education is under development. Medication may still be optimised, both qualitatively and quantitatively. Surveillance is planned with a yearly audit.
Subject(s)
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Collection: 01-internacional Health context: 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Database: MEDLINE Main subject: Heart Failure / Medical Audit Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Europa Language: En Journal: Arch Cardiovasc Dis Year: 2008 Document type: Article
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Collection: 01-internacional Health context: 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Database: MEDLINE Main subject: Heart Failure / Medical Audit Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Europa Language: En Journal: Arch Cardiovasc Dis Year: 2008 Document type: Article