IMPACT: UCLA researchers tracked heart failure in-hospital patient trends from 2002 to 2004 for 285 hospitals nationwide and found significant changes in treatment patterns and quality-of-care indicators that paralleled improvements in clinical outcomes and mortality. The study highlights the need for further efforts to accelerate improvements in care for heart failure patients.
FINDINGS: Treatment changes included decreased use of intravenous inotropic agents (drugs that make the heart work harder) and increased use of intravenous vasodilators (drugs that reduce the work the heart needs to do to help blood flow). A substantial rise in the use of oral beta-blocker medication during hospitalization was also found. Hospital compliance with key quality-of-care measures including patient receipt of discharge instructions, smoking counseling and left ventricle function measurement increased.
There was a highly significant 29 percent reduction of in-hospital mortality and 36 percent reduction in the need for mechanical ventilation. Reductions in hospital and intensive care unit length of stay were also observed. Researchers utilized data from more than 150,000 acute heart failure patient episodes, taken from the Acute Decompensated Heart Failure National Registry (ADHERE). If similar improvements had occurred at hospitals nationwide, this would translate to 14,300 less in-hospital deaths and 880,000 costly hospital days eliminated per year.
AUTHORS: Dr. Gregg C. Fonarow, Eliot Corday Chair in Cardiovascular Medicine, and professor of cardiology, David Geffen School of Medicine at UCLA, is available for interviews.
JOURNAL: The research appears online on the website of the American Heart Journal. A copy of the full study is available.
FUNDING: The study was funded by biopharmaceutical company Scios, Inc., which sponsors the ADHERE registry. The authors have received research grants and served as consultants for Scios.