Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026
PRACTICE-HF: Implementation of an updated clinical protocol for acute heart failure.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Peeters Lukas, Hoen Mick, Hofman Delian, Hompes Bjorn, Langenveld Bart, Smeets Danae, Lenderink Timo, Brunner-La Rocca Hans Peter, Sanders-van Wijk Sandra
Аннотация
BACKGROUND: Despite recent advances in the treatment of acute heart failure (AHF), implementation of new evidence into clinical practice remains challenging.
METHODS: We conducted a single-center descriptive exploratory study within an ongoing prospective AHF registry. Adult patients admitted with AHF, without requiring intensive care, were included consecutively. An updated local AHF protocol was developed and implemented by group-education sessions, pocket cards, and posters. Patients before (control group) and after (intervention group) implementation of the new protocol were compared in terms of compliance to the protocol and 90-day outcomes-blanking the implementation period. Subgroups entailed HF with (mildly) reduced and preserved ejection fraction.
RESULTS: Patients were elderly, with almost half being de novo HF patients. Groups were comparable except for higher NT-proBNP in the implementation group and a higher cancer prevalence in the control group. The intervention group showed an increase in in-hospital use of acetazolamide (59.8 vs 0%, p < 0.001), in iron deficiency testing and correct iv. iron administration (42.9% vs 78.6% p ≤ 0.001). Pre-discharge installation of SGLT2 inhibitors showed a positive trend (44.2 vs 20% in HF(m)rEF patients and 29.4 vs 4% in HFpEF, both p = 0.01) HF-event-free survival at 90 days numerically favored the intervention group (29.9 vs 44.3%, p = 0.054), whereas length of hospital stay increased by 1 day (p = 0.011).
CONCLUSION: Implementing a local updated AHF protocol improved adoption of several evidence based AHF interventions. This may translate into improved patient outcomes, against a minor increase in hospital duration.
METHODS: We conducted a single-center descriptive exploratory study within an ongoing prospective AHF registry. Adult patients admitted with AHF, without requiring intensive care, were included consecutively. An updated local AHF protocol was developed and implemented by group-education sessions, pocket cards, and posters. Patients before (control group) and after (intervention group) implementation of the new protocol were compared in terms of compliance to the protocol and 90-day outcomes-blanking the implementation period. Subgroups entailed HF with (mildly) reduced and preserved ejection fraction.
RESULTS: Patients were elderly, with almost half being de novo HF patients. Groups were comparable except for higher NT-proBNP in the implementation group and a higher cancer prevalence in the control group. The intervention group showed an increase in in-hospital use of acetazolamide (59.8 vs 0%, p < 0.001), in iron deficiency testing and correct iv. iron administration (42.9% vs 78.6% p ≤ 0.001). Pre-discharge installation of SGLT2 inhibitors showed a positive trend (44.2 vs 20% in HF(m)rEF patients and 29.4 vs 4% in HFpEF, both p = 0.01) HF-event-free survival at 90 days numerically favored the intervention group (29.9 vs 44.3%, p = 0.054), whereas length of hospital stay increased by 1 day (p = 0.011).
CONCLUSION: Implementing a local updated AHF protocol improved adoption of several evidence based AHF interventions. This may translate into improved patient outcomes, against a minor increase in hospital duration.