RESUMEN
BACKGROUND: Elderly patients with heart failure (HF) have a high degree of comorbidity which leads to fragmented care, with frequent hospitalizations and high mortality. This study evaluated the benefit of a comprehensive continuous care model (UMIPIC program) in elderly HF patients. METHODS AND RESULTS: We prospectively analyzed data from the RICA registry on 2862 patients with HF treated in internal medicine departments. They were divided into two groups: one monitored in the UMIPIC program (UMIPIC group, n: 809) and another which received conventional care (RICA group, n: 2.053). We evaluated HF readmissions during 12 months of follow-up and total mortality after episodes of HF hospitalization. UMIPIC patients were older with higher rates of comorbidity and preserved ejection fraction than the RICA group. However, the UMIPIC group had a lower rate of HF readmissions (17% vs. 26%, pâ¯<â¯.001) and mortality (16% vs. 27%, respectively; pâ¯<â¯.001). In addition, we selected 370 propensity score-matched patients from each group and the differences in HF readmissions (15% UMIPIC vs. 30% RICA; hazard ratio [HR]â¯=â¯0.44; 95% confidence interval [CI] 0.32-0.60; pâ¯<â¯.001) and mortality (17% UMIPIC vs. 28% RICA; hazard ratioâ¯=â¯0.58; 95% CI 0.42-0.79; pâ¯=â¯.001) were maintained. CONCLUSIONS: The implementation of the UMIPIC program, based on comprehensive continuous care of elderly patients with HF and high comorbidity, markedly reduce HF readmissions and total mortality.