Common precipitants of heart failure hospitalization included acute anginal chest pain (33%), respiratory infection (16%), uncontrolled hypertension (15%), and medication noncompliance (15%).
Cross-Sectional (n=435)
No
A significant proportion of heart failure hospitalizations are associated with preventable precipitants such as noncompliance and uncontrolled hypertension, and underutilization of ACE inhibitors remains an issue.
OBJECTIVES: This study identifies acute precipitants of hospitalization and evaluates utilization of angiotension-converting enzyme inhibitors in patients admitted with congestive heart failure. METHODS: Cross-sectional chart-review study was done of 435 patients admitted nonelectively from February 1993 to February 1994 to an urban university hospital with a complaint of shortness of breath or fatigue and evidence of congestive heart failure. RESULTS: The most common identifiable abnormalities associated with clinical deterioration prior to admission were acute anginal chest pain (33%), respiratory infection (16%), uncontrolled hypertension with initial systolic blood pressure > or = 180 mm Hg (15%), atrial arrhythmia with heart rate > or = 120 (8%), and noncompliance with medications (15%) or diet (6%); in 34% of patients, no clear cause could be identified. After exclusion of those who were already on a different vasodilator or who had relative contraindications, 18 (32%) of the patients with ejection fractions < or = 0.35 measured prior to admission were not taking an angiotensin-converting enzyme inhibitor on presentation to the hospital. CONCLUSIONS: Interventions to improve compliance, the control of hypertension, and the appropriate use of angiotensin-converting enzyme inhibitors may prevent many hospitalizations of heart-failure patients.
Chin et al. (1997) conducted a cross-sectional in Congestive heart failure (n=435). Precipitants of hospitalization and ACE inhibitor utilization was evaluated on Identifiable abnormalities associated with clinical deterioration prior to admission. Common precipitants of heart failure hospitalization included acute anginal chest pain (33%), respiratory infection (16%), uncontrolled hypertension (15%), and medication noncompliance (15%).