Morbidity and mortality in elderly patients with heart failure managed with a comprehensive care model vs. usual care: The UMIPIC program.
Rev Clin Esp (Barc)
; 222(3): 123-130, 2022 Mar.
Article
en En
| MEDLINE
| ID: mdl-34615617
ABSTRACT
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 ANDRESULTS:
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.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Insuficiencia Cardíaca
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
Rev Clin Esp (Barc)
Año:
2022
Tipo del documento:
Article