[The pattern of the clinical use of digitalis. The need for a reassessment]

To evaluate the pattern of utilization of digitalis in an academic hospital.

Clinical files of all patients admitted in medical wards at the Hospital de Clínicas de Porto Alegre were studied. Data were collected during five different days, three in the winter and two in the summer, keeping an interval of at least two weeks between each data collection. Heart failure diagnosis was evaluated objectively by means of a score proposed by Carlson et al.

From a total number of 881 patients, 114 (13%) were receiving digoxin. Mean age was 66 +/- 13 years and 47% were males. Considering the patients who were taking digoxin, 32% presented scores compatible with definite or possible heart failure; 26% had atrial flutter or fibrillation; 18% had heart failure and supraventricular tachyarrhythmias; and in 24% no clear indications were found according to our criteria. Previous use of digoxin was found in 85% of the patients and 32% were withdrawn during the hospitalization. Considering just the patients who had no reason for using digoxin, only 44% had the drug withdrawn.

According to current criteria, many hospitalized patients receive digoxin without a definite indication. These data suggest that reassessment of the use of digitalis should be incorporated into clinical practice.