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Hospitalization for congestive heart failure: is it still a cardiology business?
Francesco Grigioni1, Valeria Carinci, Luca Favero
1Cardiology Institute of the University Hospital S. Orsola-Malpighi, Via Massarenti n. 9, 40100, Bologna, Italy.
Insights
Hospitalized heart failure (CHF) patients treated in general medicine departments (GMD) were older, more often female, and had higher mortality than those in cardiology units (CU). Management strategies for CHF need improvement.
Area of Science:
- Cardiology
- Internal Medicine
- Hospital Administration
Background:
- Hospital management of Congestive Heart Failure (CHF) and its predictors of mortality require further clarification.
- Understanding patient disposition and outcomes in CHF hospitalizations is crucial for improving care.
Purpose of the Study:
- To analyze hospital admissions for CHF and identify factors influencing patient outcomes.
- To compare the characteristics and mortality rates of CHF patients treated in general medicine departments versus cardiology units.
Main Methods:
- Retrospective analysis of hospital admissions for CHF in 1996 at a large university hospital.
- Inclusion criteria: patients discharged with a principal diagnosis of CHF.
- Data collected included patient demographics, treatment department, length of stay, and mortality rates.
Main Results:
- 1511 patients met inclusion criteria; 75% were treated in General Medicine Departments (GMD) and 22% in Cardiology Units (CU).
- GMD patients were older (79 vs. 68 years), had a higher proportion of females (56% vs. 37%), and experienced higher hospital mortality (13% vs. 4%) compared to CU patients.
- Mean length of stay was 11 days, not significantly associated with the treatment department (P=0.273).
Conclusions:
- Congestive Heart Failure (CHF) is a significant, often fatal condition frequently managed in GMD.
- Patient characteristics, rather than departmental differences, appear to influence length of stay.
- GMD patients exhibit higher comorbidity and mortality rates, highlighting the urgent need for improved CHF hospital management strategies.
Background:
Hospital management of CHF and predictors of hospital mortality remain unclear.
Methods:
To address these issues, we analyzed the hospital admissions for CHF during 1996 in a large university hospital. Patients discharged with the principal diagnosis of CHF were considered eligible for the study.
Results:
Among the 1511 patients (3% of all discharges) who satisfied the inclusion criteria, 75% were treated in general medicine departments (GMD) and 22% in cardiology units (CU). Patients admitted to GMD were older than those treated in CU (79+/-10 vs. 68+/-15 years, P<0.001), included a higher proportion of females (56% vs. 37%, P<0.001), and presented a higher rate of hospital mortality (13% vs. 4%, P<0.001). The overall mean length of stay was 11+/-9 days. At multivariate analysis, length of stay was not associated with the department (i.e. GMD/CU) (P=0.273).
Conclusions:
CHF is a common lethal condition often requiring treatment in GMD. Length of stay appears to depend more on patients' characteristics than on differences in practice between GMD and CU. Patients admitted to GMD present higher rates of comorbidity and hospital mortality. Strategies are urgently needed to improve hospital management of CHF.