0440: Patient journey during hospitalization for acute heart failure in cardiology and geriatric departments of greater Paris university hospitals

Abstract

Acute heart failure is a major health care problem and data on patient journey before/during/after hospitalization are limited. The aim of this study was to analyze patient journey from pre-hospital to discharge in acute heart failure in a multicentre observational study. This observational study enrolled, one day per week, 257 patients with acute heart failure during five months (September 2014 – February 2015) in 14 departments of Paris (cardiology: 10; geriatrics: 4). Mean age was 77±15 years, 56% were male. First medical contact was an emergency department in 45% of cases, a general practitioner (GP) in 16%, and a cardiologist or a medical ambulance (13% each). There was a single medical actor intervention before hospitalization in 78% of cases. 64% of patients were finally admitted through emergency departments. Previous history of heart failure was common (71%) and most frequent precipitating factors were arrhythmia (29%), infection (26%) and non-compliance to medical therapy (16%). Diabetes (28%), chronic pulmonary disease (19%) and cognitive disabilities (18%) were the most frequent co-morbidities. LVEF was preserved (>50%) in 32%. In-hospital stay was 13±12 days and 61% of patients stayed in an intensive cardiologic care unit (ICCU) for an average duration of 5.5±3.9 days. 64% of patients were directly discharged home and 21% were transferred to rehabilitation care units. In-hospital mortality was 2.4%. Although heterogeneous patient admission for acute heart failure is made through emergency departments and GPs in the majority of cases, a stay in intensive care unit is observed in 61% of cases. Discharge from hospital is made at home in 2/3 of cases. Therefore, actions to improve cooperation between professionals in the management of acute heart failure should target emergency departments and GPs. Abstract 0440 – Figure