Innlandet Hospital Trust, Division Lillehammer, Department of Medicine, Lillehammer, Norway.
Eur J Cardiovasc Nurs. 2011 Mar;10(1):44-9. doi: 10.1016/j.ejcnurse.2010.04.001. Epub 2010 May 8.
Hospitalization rates, morbidity and mortality are undesirably high in heart failure (HF) patients. An organized system of HF specialist outpatient care has been recommended, but the best way to implement such programmes is not clearly established.
To evaluate HF patient characteristics, management and outcome in outpatient HF clinics.
Data from HF patients at 24 hospital outpatient clinics were entered in a common database allowing each centre to monitor its own practice against the rest.
A total of 3632 patients were included. At the last registered visit, ACE inhibitors or angiotensin receptor blockers were prescribed for 87%; beta blockers, 83%; spironolactone, 33% and loop diuretics 87% of the patients. The number of hospital admissions and days stayed in hospital for cardiovascular reasons were significantly reduced (p<0.001). Mortality was high, 11.5 and 22% after one and two years, respectively.
The use of evidence-based medication increased over time in HF clinics with the ability of the individual clinics to compare their treatment to other sites. Thus, establishment of specialized HF clinics managed in a registry network might improve the quality of care.
心力衰竭（HF）患者的住院率、发病率和死亡率都高得令人不快。已经推荐了一种有组织的 HF 专科门诊护理系统，但实施此类计划的最佳方式尚不清楚。
评估门诊 HF 诊所中 HF 患者的特征、管理和结局。
将 24 家医院门诊的 HF 患者的数据输入一个通用数据库，使每个中心都能根据其余中心的情况监测自己的实践情况。
共纳入 3632 例患者。在最后一次就诊时，87%的患者服用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂，83%的患者服用β受体阻滞剂，33%的患者服用螺内酯，87%的患者服用噻嗪类利尿剂。因心血管原因住院的人数和住院天数明显减少（p<0.001）。死亡率很高，分别为 11.5%和 22%，在 1 年和 2 年后。
随着时间的推移，HF 诊所中基于证据的药物治疗使用率有所增加，各个诊所也能够将自己的治疗方案与其他诊所进行比较。因此，建立专门的 HF 诊所，并在注册网络中进行管理，可能会提高护理质量。
