Key result
Patients with congestive heart failure admitted to general medicine departments had significantly higher hospital mortality compared to those treated in cardiology units (13% vs. 4%, P<0.001).
Why the study?
Does treatment in general medicine departments compared to cardiology units affect hospital mortality and length of stay in patients with congestive heart failure?
Observational (n=1,511)
No
Does treatment in general medicine departments compared to cardiology units affect hospital mortality and length of stay in patients with congestive heart failure?
Absolute Event Rate: 13% vs 4%
p-value: p=<0.001
Most CHF patients are treated in general medicine departments where they are older, more often female, and have higher hospital mortality compared to those in cardiology units.
HF admissions should not yet shift to cardiology units; leaves open whether setting affects mortality or reflects selection in this cohort.
BACKGROUND: Hospital management of CHF and predictors of hospital mortality remain unclear. METHODS: To address these issues, we analyzed the hospital admissions for CHF during 1996 in a large university hospital. Patients discharged with the principal diagnosis of CHF were considered eligible for the study. RESULTS: Among the 1511 patients (3% of all discharges) who satisfied the inclusion criteria, 75% were treated in general medicine departments (GMD) and 22% in cardiology units (CU). Patients admitted to GMD were older than those treated in CU (79+/-10 vs. 68+/-15 years, P<0.001), included a higher proportion of females (56% vs. 37%, P<0.001), and presented a higher rate of hospital mortality (13% vs. 4%, P<0.001). The overall mean length of stay was 11+/-9 days. At multivariate analysis, length of stay was not associated with the department (i.e. GMD/CU) (P=0.273). CONCLUSIONS: CHF is a common lethal condition often requiring treatment in GMD. Length of stay appears to depend more on patients' characteristics than on differences in practice between GMD and CU. Patients admitted to GMD present higher rates of comorbidity and hospital mortality. Strategies are urgently needed to improve hospital management of CHF.
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Grigioni et al. (2002) conducted an observational in Congestive Heart Failure (n=1,511). General medicine departments vs. Cardiology units was evaluated on Hospital mortality (p=<0.001). Patients with congestive heart failure admitted to general medicine departments had significantly higher hospital mortality compared to those treated in cardiology units (13% vs. 4%, P<0.001).
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