Resultados asistenciales de una consulta monográfica para pacientes con insuficiencia cardíaca. Estudio de cohortes

Abstract

Objetive: The target of this study is to determine the impact of a monographic consultation for Chronic Heart Failure (CHF) on functional status and hospitalization of those patients. Material and Methods: Prospective cohort study included 456 patients admitted to the Internal Medicine Unit with CHF. Upon discharge patients were divided into two similar groups, one control group that went through routine monitoring, and one intervention group made of patients subject to monitoring through monographic consultation for CHF. The study was conducted from January 6th to April 9th. Both cohorts were compared in terms of the number of urgent service visits, hospital readmissions, readmission rates and mortality average at hospital admission. Results: The NYHA functional classification of patients subject to monitoring through monographic consultation as opposed to control group worsened significantly less (1.42 vs. 2.05) (p< 0.001), the number of ER visits was considerably lower (66% vs 155%) (p<0,001); the readmission rate was significantly reduced (81% vs 50.5%) (p=0,002); the average hospital stay was significantly lower (18 days vs 25 days) (p<0,001). And the mortality upon readmission was 13% lower as opposed to 27.8% (p<0�006). Conclusion: In older patients, following a health program in which internists and specialized nursing have a main role and which is based on a continuous tracking, a personalized therapeutic optimization, control for comorbidity, information / training and availability, is a good way to diminish functional deterioration, reducing urgents visits and readmissions, as well as reducing hospital stay and mortality.