Heart Failure in a Dedicated Outpatient Clinic: Results after 58 Month Follow-Up. Can it be Enough?

Area of Science:

• Cardiology
• Public Health

Background:

• Chronic heart failure (HF) incidence is rising, particularly in older adults.
• Despite medical advances, HF prognosis remains poor, with high one-year mortality.
• Current HF management guidelines recommend outpatient clinics, but patient adherence is a significant issue.

Purpose of the Study:

• To evaluate the impact of a dedicated heart failure outpatient clinic on mortality, hospitalization, and abandonment rates over 58 months.
• To assess the effectiveness of structured follow-up in managing chronic heart failure patients.

Main Methods:

• Analysis of 58 months of activity from a dedicated HF outpatient clinic.
• Enrollment of 477 HF patients (mean age 69.6 years) with a mean follow-up of 18.2 months.
• Comparison of hospitalization and mortality rates before and during outpatient clinic follow-up.

Main Results:

• Total mortality rate was 11.5% (4% per year).
• Hospitalizations for acute decompensated heart failure significantly decreased from 0.49 to 0.29 per patient-year (p=0.015).
• 19% of patients abandoned the clinic, primarily within the initial months.

Conclusions:

• Dedicated HF outpatient clinics lead to a significant reduction in acute decompensation events and hospital admissions.
• Improving patient adherence to outpatient programs is crucial for maximizing the benefits of HF management.
• The study highlights the value of specialized clinics in improving outcomes for a growing chronic heart failure population.