Outpatient management at a heart failure clinic significantly reduced the risk of 1-month all-cause death or cardiac rehospitalisation compared with usual care (adjusted OR 0.23; 95% CI 0.12-0.46).
Cohort (n=339)
Does outpatient management at a specific heart failure clinic reduce all-cause death or cardiac-cause rehospitalisation in patients discharged after a heart failure hospitalization?
Outpatient management at a dedicated heart failure clinic significantly reduces short-term death or readmission and improves long-term survival compared to usual care.
Effect estimate: adjusted OR 0.23 (95% CI 0.12-0.46)
Ambulatory care by physicians especially devoted to the management of heart failure (HF) has been reported to have beneficial effects. The aim of this work was to assess the effect of outpatient management at a HF clinic, as compared with care by the usual assistant physician, on prognosis of HF patients. In this non-randomised study, we prospectively followed 339 patients after a hospitalisation index for HF, in order to compare prognosis between two groups of HF patients according to the ambulatory assistance setting: either a specific outpatient clinic (n=157) or the usual assistant physician (n=182). The outcomes assessed were all-cause death or cardiac-cause rehospitalisation during the first month after discharge and survival over the longer term. The risk of dying or being readmitted during the first month after discharge was significantly lower in patients followed at the HF clinic (adjusted odds ratio 0.23; 95% CI 0.12-0.46). Patients followed in the HF clinic also had an independent significantly lower hazard of dying during a longer-term follow up of average length 373 days (adjusted hazard ratio 0.52; 95% CI 0.34-0.81). The results support the fact that a multidisciplinary and permanently available medical staff might be of relevance in improving outcomes in HF patients.
Azevedo et al. (Sat,) conducted a cohort in Heart failure (n=339). Outpatient management at a specific heart failure clinic vs. Care by the usual assistant physician was evaluated on All-cause death or cardiac-cause rehospitalisation during the first month after discharge (adjusted OR 0.23, 95% CI 0.12-0.46). Outpatient management at a heart failure clinic significantly reduced the risk of 1-month all-cause death or cardiac rehospitalisation compared with usual care (adjusted OR 0.23; 95% CI 0.12-0.46).