Risk of readmission and death after hospitalization for worsening heart failure: Role of post-discharge follow-up visits in a real-world study from the Grand Est Region of France

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • João Pedro Melo Marques Pinho Ferreira

    Autor

Participantes de fora da FMUP

  • Baudry, G
  • Pereira, O
  • Duarte, K
  • Savarese, G
  • Welter, A
  • Tangre, P
  • Lamiral, Z
  • Agrinier, N
  • Girerd, N

Unidades de investigação

Abstract

Aims Patients who experience hospitalizations due to heart failure (HF) face a significant risk of readmission and mortality. Our objective was to evaluate whether the risk of hospitalization and mortality following discharge from HF hospitalization differed based on adherence to the outpatient follow-up (FU) protocol comprising an appointment with a general practitioner (GP) within 15 days, a cardiologist within 2 months or both (termed combined FU).Methods and results We studied all adults admitted for a first HF hospitalization from 2016 to 2020 in France's Grand Est region. Association between adherence to outpatient FU and outcomes were assessed with time-dependent survival analysis model. Among 67 476 admitted patients (mean age 80.3 +/- 11.3 years, 53% women), 62 156 patients (92.2%) were discharged alive and followed for 723 (317-1276) days. Combined FU within 2 months was used in 21.1% of patients, with lower rates among >85 years, women, and those with higher comorbidity levels (p < 0.0001 for all). Combined FU was associated with a lower 1-year death or rehospitalization (adjusted hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.88-0.94, p < 0.0001) mostly related to lower mortality (adjusted HR 0.65, 95% CI 0.62-0.68, p < 0.0001) whereas HF readmission was higher (adjusted HR 1.19, 95% CI 1.15-1.24, p < 0.0001). When analysing components of combined FU separately, 1-year mortality was more related to cardiologist FU (HR 0.65, 95% CI 0.62-0.67, p < 0.0001), than GP FU (HR 0.87, 95% CI 0.85-0.90, p < 0.0001).Conclusion Combined FU is carried out in a minority of patients following HF hospitalization, yet it is linked to a substantial reduction in 1-year mortality, albeit at the expense of an increase in HF hospitalizations. [GRAPHICS]

Dados da publicação

ISSN/ISSNe:
1388-9842, 1879-0844

European Journal of Heart Failure  Wiley-Blackwell

Tipo:
Article
Páginas:
342-354
Link para outro recurso:
www.scopus.com

Citações Recebidas na Scopus: 5

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Keywords

  • Cardiovascular diseases; Heart failure; Epidemiology; Survival; Healthcare pathways

Financiamento

Proyectos asociados

Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684

Investigador Principal: João Pedro Melo Marques Pinho Ferreira

Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022

Initiation of ARNi and SGLT2i in Patients With HFrEF: Randomized Open-label Trial (INITIATE-HFrEF) -NCT05989503

Investigador Principal: João Pedro Melo Marques Pinho Ferreira

Ensaio Clínico Académico (INITIATE-HFrEF) . Novartis . 2023

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