Abstract 15980: Effectiveness of Heart Failure Clinic on Clinical Outcomes after Discharge in Patients with Acute Decompensated Heart Failure

Abstract

Background. Management of heart failure needs multidisciplinary approach to provide optimum quality of life. Previous researchers reported clinical outcomes of chronic ambulatory heart failure outpatients via heart failure clinic. However, there is a lack of evidence to support clinical effectiveness of heart failure clinic after discharge in patients with acute decompensated heart failure.

Purpose. We hypothesized that patients followed by heart failure clinic would have less rehospitalizations and mortality than those followed by the usual care clinic.

Methods. A total of 202 patients with acute decompensated heart failure consist of 104 patients (age 65±14 years, 39% female) with heart failure clinic and 98 patients (age 66±13 years, 39% female) with usual care clinic were investigated. The heart failure clinic provided comprehensive non-pharmacological interventions as well as pharmacological education by a nurse with expertise in heart failure. Cox proportional hazard regression model was used to compare the time to first event of rehospitalization and all-cause mortality between patients with heart failure clinic and those with usual care clinic.

Results. There were 68 heart failure rehospitalizations and 28 deaths in the heart failure clinic, as compared with 93 heart failure rehospitalizations and 34 deaths in the usual care clinic during the mean follow-up period of 420 days. Patients in usual care clinic had significantly higher rehospitalization rate (hazard ratio [HR] = 2.01, 95% CI 1.18-3.41, p = 0.010) and all-cause mortality (HR = 3.37, 95% CI 1.28-8.87, p = 0.014) after controlling for age, gender, body mass index, ejection fraction, etiology of heart failure, comorbidities, and medications.

Conclusions. Our study suggested a clinical usefulness of heart failure clinic after discharge in patients with acute decompensated heart failure. Further studies are in need incorporating evidence-based heart failure management program development.