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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

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Readmissions and the quality of care in patients hospitalized with heart failure

Jean-Christophe Luthi1, Mary Jo Lund, Laura Sampietro-Colom

  • 1Institute of Social and Preventive Medicine, University of Lausanne, Switzerland. Jean-Christophe.Luthi@inst.hospvd.ch

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|October 7, 2003
PubMed

Insights

Prescribing angiotensin-converting enzyme inhibitors (ACEI) at recommended doses for patients with heart failure and left ventricular systolic dysfunction (LVSD) is associated with fewer hospital readmissions. Adhering to guidelines improves patient outcomes.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Clinical guidelines recommend angiotensin-converting enzyme inhibitors (ACEI) for heart failure with left ventricular systolic dysfunction (LVSD).
  • Optimal dosing of ACEI aims to reduce mortality and hospital readmissions.

Purpose of the Study:

  • To investigate the association between ACEI use at discharge and subsequent readmission rates in LVSD patients.
  • To evaluate adherence to ACEI prescribing guidelines in heart failure management.

Main Methods:

  • Retrospective analysis of medical records from 611 eligible patients hospitalized for heart failure.
  • Data abstracted on ACEI prescription at discharge (recommended dose, less than recommended, or none).
  • Readmission rates assessed up to 21 months post-discharge.

Main Results:

  • Patients not prescribed ACEI at discharge had a 1.74 times higher readmission rate (RR 1.74, 95% CI 1.22-2.48).
  • Patients on sub-therapeutic ACEI doses had a 1.24 times higher readmission rate (RR 1.24, 95% CI 0.91-1.69).
  • A significant trend (P=0.005) indicated lower readmissions with increasing ACEI dose adequacy.

Conclusions:

  • ACEI use at discharge is linked to reduced readmission rates in LVSD patients.
  • Compliance with ACEI prescribing guidelines for heart failure offers significant clinical benefits.
  • Optimizing ACEI therapy is crucial for managing heart failure and preventing readmissions.
Abstract

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