Improved outcome with standardized plan for clinical management of acute decompensated chronic heart failure
(2019) In Journal of Geriatric Cardiology 16(1). p.12-18- Abstract
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... (More)
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. Conclusion 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.
(Less)
- author
- Edvinsson, Marie Louise LU ; Stenberg, Albin and Åström-Olsson, Karin LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic heart failure, Medication, NT-proBNP, Prognosis
- in
- Journal of Geriatric Cardiology
- volume
- 16
- issue
- 1
- pages
- 7 pages
- publisher
- Science Press
- external identifiers
-
- pmid:30800146
- scopus:85061488879
- ISSN
- 1671-5411
- DOI
- 10.11909/j.issn.1671-5411.2019.01.002
- language
- English
- LU publication?
- yes
- id
- e23d2454-d5e9-4765-b7f8-fa16e34a1b62
- date added to LUP
- 2019-02-21 13:21:42
- date last changed
- 2024-08-20 10:54:25
@article{e23d2454-d5e9-4765-b7f8-fa16e34a1b62, abstract = {{<p>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. Conclusion 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.</p>}}, author = {{Edvinsson, Marie Louise and Stenberg, Albin and Åström-Olsson, Karin}}, issn = {{1671-5411}}, keywords = {{Chronic heart failure; Medication; NT-proBNP; Prognosis}}, language = {{eng}}, number = {{1}}, pages = {{12--18}}, publisher = {{Science Press}}, series = {{Journal of Geriatric Cardiology}}, title = {{Improved outcome with standardized plan for clinical management of acute decompensated chronic heart failure}}, url = {{http://dx.doi.org/10.11909/j.issn.1671-5411.2019.01.002}}, doi = {{10.11909/j.issn.1671-5411.2019.01.002}}, volume = {{16}}, year = {{2019}}, }