Key result
Specialized CHF center care is linked to ~75% lower one-year mortality versus standard outpatient clinics.
Why the study?
The worsening prognosis in patients with chronic heart failure after acute heart failure decompensation requires evaluation of different outpatient treatment and rehabilitation strategies.
Does observation in a specialized urban center for CHF reduce overall mortality in patients with CHF after acute decompensation compared to standard outpatient care?
Cohort (n=648)
No
Does observation in a specialized urban center for CHF reduce overall mortality in patients with CHF after acute decompensation compared to standard outpatient care?
Odds Ratio: 4 (95% CI 2.2–7.4)
Absolute Event Rate: 4.13% vs 14.83%
p-value: p=<0.001
Management in a specialized multidisciplinary heart failure center significantly reduces 1-year mortality compared to standard outpatient care following acute decompensation.
Two monitoring strategies after AHFD differ in CHF outpatients; leaves open optimal approach before practice change.
Relevance. Data from epidemiological studies indicate an increase in the number of patients with chronic heart failure (CHF) in the Russian Federation over the past 18 years. The worsening of the prognosis in patients with CHF after the episode of acute heart failure decompensation (AHFD) requires changes in the tactics of treatment and rehabilitation of patients on an outpatient basis. The goal is to identify the differences in the two strategies for monitoring patients with CHF after AHFD and determine the effectiveness of treatment, rehabilitation and life expectancy, depending on the observation of a specialized urban center for the treatment of CHF (CCHF) and real outpatient practice in the system. Materials and methods. The study included 648 patients with CHF of any etiology older than 18 years. The first group consisted of 412 patients with CHF who were observed for AHFD in the stationary department of the CCHF and, after discharge, continued rehabilitation in the outpatient department of the CCHF; the 2 nd - 236 patients with CHF who, after discharge for AHFD from the department of the CCHF, preferred observation in outpatient clinics in Nizhny Novgorod. Results. After one year of follow-up, the overall mortality rate in the 1st group was 4.13%, and in the second group it was 14.83% (odds ratio 4.0, 95% confidence interval 2.2-7.4, p
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Фомин et al. (2017) conducted a cohort in Chronic heart failure after acute decompensation (n=648). Observation in a specialized urban center for the treatment of CHF vs. Observation in standard outpatient clinics was evaluated on Overall mortality rate at 1 year (OR 4.0, 95% CI 2.2-7.4, p=<0.001). Observation in a specialized urban center for chronic heart failure significantly reduced one-year overall mortality to 4.13% compared to 14.83% in standard outpatient clinics (OR 4.0).
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