Rehospitalization for Heart Failure Problems and Perspectives

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:61

Review

Gheorghiade, Mihai¹  Vaduganathan, Muthiah²  Fonarow, Gregg C.³  Bonow, Robert O.¹ 

[1] Northwestern Univ, Feinberg Sch Med, Ctr Cardiovasc Innovat, Chicago, IL 60611 USA

[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med, Boston, MA USA

[3] Ronald Reagan UCLA Med Ctr, Ahmanson UCLA Cardiomyopathy Ctr, Los Angeles, CA USA

关键词: heart failure;    outcomes;    readmission;   

DOI  :  10.1016/j.jacc.2012.09.038

来源: Elsevier

【 摘 要 】

With a prevalence of 5.8 million in the United States alone, heart failure (HF) is associated with high morbidity, mortality, and healthcare expenditures. Close to 1 million hospitalizations for heart failure (HHF) occur annually, accounting for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States. Although some progress has been made in reducing mortality in patients hospitalized with HF, rates of rehospitalization continue to rise, and approach 30% within 60 to 90 days of discharge. Approximately half of HHF patients have preserved or relatively preserved ejection fraction (EF). Their post-discharge event rate is similar to those with reduced EF. HF readmission is increasingly being used as a quality metric, a basis for hospital reimbursement, and an outcome measure in HF clinical trials. In order to effectively prevent HF readmissions and improve overall outcomes, it is important to have a complete and longitudinal characterization of HHF patients. This paper highlights management strategies that when properly implemented may help reduce HF rehospitalizations and include adopting a mechanistic approach to cardiac abnormalities, treating noncardiac comorbidities, increasing utilization of evidence-based therapies, and improving care transitions, monitoring, and disease management. (J Am Coll Cardiol 2013;61:391-403) (C) 2013 by the American College of Cardiology Foundation

【 授权许可】

Free