The Israel Medical Association journal : IMAJ · 2006
Adherence to guidelines for patients hospitalized with heart failure: a nationwide survey.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Jotkowitz Alan B, Porath Avi, Shotan Avraham, Mittelman Moshe, Grossman Ehud, Zimlichman Reuven, Lewis Basil S, Caspi Abraham, Gottlieb Shmuel, Garty Moshe, Steering Committee of the Israel Heart Failure National Survey 2003
Аннотация
BACKGROUND: Despite significant advances in the therapy of heart failure, many patients still do not receive optimal treatment.
OBJECTIVES: To document the standard of care that patients hospitalized with HF in Israel received during a 2 month period.
METHODS: The Heart Failure Survey in Israel 2003 was a prospective 2 month survey of patients admitted to all 25 public hospitals in Israel with a diagnosis of HF.
RESULTS: The mean age of the 4102 patients was 73 years and 43% were female. The use of angiotensin-converting enzyme/angiotensin receptor blockers and beta blockers both declined from NYHA class I to IV (68.8% to 50.6% for ACE-inhibitor/ARB and 64.1% to 52.9% for beta blockers, P < 0.001 for comparisons). The percentage of patients by NYHA class taking an ACE-inhibitor or ARB and a beta blocker at hospital discharge also declined from NYHA class I to IV (47.5% to 28.8%, P < 0.002 for comparisons). The strongest predictor of being discharged with an ACE-inhibitor or ARB was the use of these medications at hospital admission. Negative predictors for their usage were age, creatinine, disease severity class, and functional status.
CONCLUSIONS: Despite the dissemination of guidelines many patients did not receive optimal care for HF. Reasons for this discrepancy need to be identified and modified.
OBJECTIVES: To document the standard of care that patients hospitalized with HF in Israel received during a 2 month period.
METHODS: The Heart Failure Survey in Israel 2003 was a prospective 2 month survey of patients admitted to all 25 public hospitals in Israel with a diagnosis of HF.
RESULTS: The mean age of the 4102 patients was 73 years and 43% were female. The use of angiotensin-converting enzyme/angiotensin receptor blockers and beta blockers both declined from NYHA class I to IV (68.8% to 50.6% for ACE-inhibitor/ARB and 64.1% to 52.9% for beta blockers, P < 0.001 for comparisons). The percentage of patients by NYHA class taking an ACE-inhibitor or ARB and a beta blocker at hospital discharge also declined from NYHA class I to IV (47.5% to 28.8%, P < 0.002 for comparisons). The strongest predictor of being discharged with an ACE-inhibitor or ARB was the use of these medications at hospital admission. Negative predictors for their usage were age, creatinine, disease severity class, and functional status.
CONCLUSIONS: Despite the dissemination of guidelines many patients did not receive optimal care for HF. Reasons for this discrepancy need to be identified and modified.
Предметные рубрики MeSH
Adrenergic beta-AntagonistsAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsCalcium Channel BlockersDiureticsDrug Utilization ReviewFemaleGuideline AdherenceHealth Care SurveysHeart FailureHospitals, PublicHumansIsraelMaleMiddle AgedMineralocorticoid Receptor AntagonistsMyocardial IschemiaPatient AdmissionPatient DischargePractice Guidelines as TopicProspective StudiesQuality of Health CareSpironolactone