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Acute decompensated heart failure: diagnosis and management
1Head of Postgraduate Education (Nursing), Royal Brompton and Harefield NHS Foundation Trust and Course Director, MSc Cardiorespiratory Nursing, Imperial College, London.
British Journal of Nursing (Mark Allen Publishing)
|December 17, 2013
Summary
Chronic heart failure (CHF) affects many older UK adults, often diagnosed during emergency visits. Despite improved management, prognosis remains poor, with significant mortality risks both in-hospital and within a year of discharge.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Chronic heart failure (CHF) is a prevalent condition in the UK, particularly affecting the elderly population.
- Prevalence increases with age, impacting approximately 15% of individuals over 75 years old.
- Many CHF patients are diagnosed following emergency department visits for severe breathlessness.
Purpose of the Study:
- To summarize the epidemiological data on chronic heart failure prevalence and outcomes in the UK.
- To highlight the significant mortality rates associated with heart failure diagnosis and hospital admission.
- To underscore the poor prognosis despite advances in patient management.
Main Methods:
- Review of epidemiological studies on heart failure prevalence in the UK.
- Analysis of national audit data concerning in-hospital mortality for acute heart failure.
- Examination of mortality risk within 6 months of diagnosis and 12 months post-discharge.
Main Results:
- An estimated 14% of heart failure patients die within 6 months of diagnosis (north west London study).
- Approximately 11% of patients admitted with acute heart failure die during their hospital stay (UK national audit).
- Patients discharged after hospitalization face a greater than 25% risk of death within 12 months.
Conclusions:
- Chronic heart failure carries a poor prognosis with high mortality rates.
- In-hospital and 12-month post-discharge mortality risks are substantial.
- Patient outcomes appear linked to inpatient management strategies and organized follow-up care.
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