18 Oct Heart Failure Care in Patients Admitted for Other Diagnoses
MedicalResearch.com: What are the main findings of the study?
Dr. Blecker: Inpatient quality of care has focused primarily on patients with acute heart failure, commonly identified by principal discharge diagnosis code. However, patients with heart failure are commonly hospitalized for other causes and should benefit from many of the same treatments.
We found that in our sample, as compared to patients with a principal diagnosis of heart failure, heart failure patients hospitalized with a non–heart failure diagnosis had lower rates of guideline-concordant care, including assessment of left ventricular function and prescription for an ACE inhibitor or ARB, at time of discharge. This is important as our study suggests that these therapies were associated with reduced mortality for patients hospitalized with heart failure, regardless of the reason for hospitalization.
MedicalResearch.com: Where any of the findings unexpected?
Dr. Blecker: The number of patients prescribed an ACE inhibitors or ARB at time of discharge was surprisingly low for hospitalized patients with systolic heart failure; only 64% of patients with a principal diagnosis of heart failure and 56% of patients with another principal diagnosis received one of these medications. Our study was limited in its ability to account for physician exception for these medications, but these numbers were still much lower than we expected.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Blecker: Hospitalizations of heart failure patients represent an opportunity for physicians to ensure that patients are receiving guideline recommended care that has been associated with improved outcomes. Our findings suggest that providers need to be aware of the quality of care delivered to hospitalized patients with heart failure regardless of the reason for hospitalization.
Department of Population Health, NYU School of Medicine, New York, NY; Department of Medicine, NYU School of Medicine, New York, NY.
Am Coll Cardiol. 2013 Sep 25. pii: S0735-1097(13)05349-7. doi: 10.1016/j.jacc.2013.08.1628.