British heart journal · 1994
Evidence of inadequate investigation and treatment of patients with heart failure.
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Clarke K W, Gray D, Hampton J R
Аннотация
OBJECTIVE: To determine the referral rates to hospital and level of investigation of patients with heart failure, and to assess whether they are receiving optimum management.
DESIGN: A retrospective survey.
SETTING: Nottingham Health District.
PATIENTS: 505 patients receiving loop diuretic treatment prescribed by their general practitioner.
MAIN OUTCOME MEASURES: Referral to hospital as an inpatient or outpatient for assessment of assumed cardiac failure; investigations--electrocardiography, chest radiography, and echocardiography; treatment with angiotensin converting enzyme inhibitors.
RESULTS: Only 56% of patients prescribed loop diuretics fulfilled the diagnostic criteria for heart failure. Of these, 74% had been referred to hospital, of whom 80% had had an electrocardiograph, 75% a chest radiograph, but only 31% an echocardiogram. Only 17% of patients with heart failure were being treated with angiotensin converting enzyme inhibitors in conjunction with loop diuretics.
CONCLUSIONS: Patients with heart failure in the Nottingham Health District are not being adequately investigated or receiving the optimum treatment.
DESIGN: A retrospective survey.
SETTING: Nottingham Health District.
PATIENTS: 505 patients receiving loop diuretic treatment prescribed by their general practitioner.
MAIN OUTCOME MEASURES: Referral to hospital as an inpatient or outpatient for assessment of assumed cardiac failure; investigations--electrocardiography, chest radiography, and echocardiography; treatment with angiotensin converting enzyme inhibitors.
RESULTS: Only 56% of patients prescribed loop diuretics fulfilled the diagnostic criteria for heart failure. Of these, 74% had been referred to hospital, of whom 80% had had an electrocardiograph, 75% a chest radiograph, but only 31% an echocardiogram. Only 17% of patients with heart failure were being treated with angiotensin converting enzyme inhibitors in conjunction with loop diuretics.
CONCLUSIONS: Patients with heart failure in the Nottingham Health District are not being adequately investigated or receiving the optimum treatment.
Предметные рубрики MeSH
AgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsCardiology Service, HospitalDiureticsDrug Therapy, CombinationEchocardiographyElectrocardiographyEnglandFamily PracticeFemaleHeart FailureHumansMaleMedical AuditQuality of Health CareReferral and ConsultationRetrospective StudiesTreatment Failure