Department of Cardiology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France.
Arch Cardiovasc Dis. 2010 Feb;103(2):90-6. doi: 10.1016/j.acvd.2009.12.006. Epub 2010 Feb 26.
Heart failure is the leading cause of hospital admissions and an economic burden. In accordance with European guidelines, a dedicated heart failure unit was created in René Dubos Hospital (Pontoise, France) in 2002.
To evaluate the impact of an in-hospital heart failure management unit on heart failure prognosis.
We conducted a descriptive study of all-cause in-hospital mortality and heart failure related readmission rates in the year after the first admission for heart failure, from January 1997 to December 2007. The Chi(2) test, a trend test and linear regression were performed.
There were no significant differences in patient characteristics (age, sex, diabetes mellitus, left ventricular ejection fraction<45%) other than renal insufficiency, in patients admitted for heart failure from 1997 to 2007. After the creation of the heart failure unit, we observed a significant decrease in heart failure related readmission rate from 21.7% in 2002 to 15.6% in 2007 (p<0.0001), whereas there was no difference in this rate before the creation of the unit (34.3% in 1997 and in 2001; p=0.90). All-cause in-hospital mortality rate decreased from 9.3% in 1997 to 5.1% in 2007 (p<0.0001) and showed a tendency to decrease after the creation of the heart failure unit (p=0.06).
Heart failure related readmission rates in new patients in the year after the first admission for heart failure reduced dramatically after the creation of the heart failure unit. All-cause in-hospital mortality in heart failure patients decreased over the 10-year study period.
心力衰竭是住院的主要原因，也是一个经济负担。根据欧洲指南，2002 年在法国蓬图瓦兹的勒内·迪博医院设立了一个专门的心力衰竭病房。
评估院内心力衰竭管理病房对心力衰竭预后的影响。
我们对 1997 年 1 月至 2007 年 12 月期间首次因心力衰竭入院后 1 年内的全因住院死亡率和心力衰竭相关再入院率进行了描述性研究。采用卡方检验、趋势检验和线性回归。
除肾功能不全外，2002 年至 2007 年期间，心力衰竭患者的特征（年龄、性别、糖尿病、左心室射血分数<45%）无显著差异。心力衰竭病房成立后，心力衰竭相关再入院率从 2002 年的 21.7%显著下降至 2007 年的 15.6%（p<0.0001），而在该病房成立之前，该比率无差异（1997 年和 2001 年为 34.3%；p=0.90）。全因住院死亡率从 1997 年的 9.3%降至 2007 年的 5.1%（p<0.0001），并且在心力衰竭病房成立后呈下降趋势（p=0.06）。
心力衰竭病房成立后，首次心力衰竭入院后 1 年内新患者的心力衰竭相关再入院率显著下降。心力衰竭患者的全因住院死亡率在 10 年研究期间有所下降。
