Key result
The combination of unstructured primary care follow-up and prior heart failure exacerbations was associated with a higher risk of 12-month HF exacerbation (HR 2.83; 95% CI 1.60-5.03; p<0.001).
Why the study?
The study was conducted to evaluate the risk of new heart failure exacerbations in patients discharged from emergency departments without structured heart failure follow-up.
Does unstructured heart failure follow-up in primary care increase the risk of new emergency department visits or heart failure-related hospitalizations in patients discharged after acute heart failure?
Cohort (n=779)
No
Does unstructured heart failure follow-up in primary care increase the risk of new emergency department visits or heart failure-related hospitalizations in patients discharged after acute heart failure?
Hazard Ratio: 2.83 (95% CI 1.6–5.03)
p-value: p=< 0.001
Discharging acute heart failure patients to primary care without structured follow-up significantly increases the risk of recurrent exacerbations and hospitalizations within 12 months.
Identifies high-risk patients for structured follow-up; hypothesis-generating for trials testing care transitions.
(1) Objective. The aim was to evaluate the risk of new exacerbations of heart failure (HF) in patients discharged from hospital emergency departments (EDs) without a structured HF follow-up. (2) Methods. This prospective, single-center cohort study included patients discharged from the ED following hospital admission for acute HF. The study analyzed the profile of patients seen in the ED and assessed their risk of new ED visits or HF-related hospitalizations within 12 months of discharge. (3) Results. A total of 779 patients were included, with a mean age of 82 ± 8 years; 471 were women (60.4%), and 674 (86.7%) had a history of prior HF episodes. Of these, 591 patients (76.1%) were referred to an unstructured HF follow-up in primary care (PC). Patients who experienced HF exacerbations within 12 months of ED discharge had a higher incidence of chronic kidney disease, elevated natriuretic peptide levels, and a higher number of prior HF exacerbations and were more likely to receive unstructured HF follow-up in PC. The presence of the last two factors was associated with the highest risk of HF exacerbation within 12 months of discharge (HR: 2.83; 95% CI: 1.60–5.03; p < 0.001). (4) Conclusions. Patients discharged from the ED after an HF episode and referred to PC without a structured HF follow-up have a high risk of ED revisits or rehospitalization for HF.
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Báez‐Ferrer et al. (2024) conducted a cohort in acute heart failure (n=779). Unstructured HF follow-up in primary care and prior HF exacerbations was evaluated on new ED visits or HF-related hospitalizations within 12 months of discharge (HR 2.83, 95% CI 1.60-5.03, p=< 0.001). The combination of unstructured primary care follow-up and prior heart failure exacerbations was associated with a higher risk of 12-month HF exacerbation (HR 2.83; 95% CI 1.60-5.03; p<0.001).
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