P1470Heart failure patients with high Charlson co-morbidity scores can be managed safely in a day-case ambulatory heart failure unit without the need for hospital admission

Introduction: Heart failure (HF) is associated with clinically significant co-morbidities and the Charlson co-morbidity index (CCI) has been validated as a risk predictor for higher mortality. Patients with significant co-morbidities are also more likely to require hospital admission and have longer duration of in-hospital stay. A specialist nurse-delivered HF unit with multi-disciplinary approach could safely manage these patients in an ambulatory setting without the need for hospital admission. Purpose: Our ambulatory HF unit (AHFU) receives referrals from emergency department, primary care and community teams. The unit also provides IV diuretics (if required) in an ambulatory setting. The outcome and safety of ambulatory treatment in HF patients with significant co-morbidities has not previously been tested. We therefore analysed the outcome of these patients based on their CCI Methods: Co-morbidities were analysed for 82 consecutive patients treated with intravenous diuretics in the AHFU over a 1.5 year period. A multi-disciplinary approach was used with regular input from day case renal, pleural and ascites clinics, as well as palliative care team. Data for mean CCI was computed according to low (1–2), moderate (3–4) or high (≥5). Range of follow-up was 6–24 months. HF admissions were assessed pre and post AHFU. CCI data was computed as mean±SEM and statistical analysis was performed using Student's t-test and chi-squared test where appropriate.