0545: 3 years experiences of a heart failure management unit in Bordeaux: results and prognosis factors

Abstract

Heart failure is the leading cause of hospital admissions and economic burden. In accordance with guidelines, a dedicated heart failure unit has been created in Bordeaux (France) in May 2011. Evaluate the impact of a heart failure management unit with ambulatory sector on readmission rate and mortality; and identify prognosis parameters at diagnosis and 6 months after. Descriptive study of mortality and heart-failure-related readmission rates after a first admission for heart failure, from May 2011 to July 2014 (inclusion stopped in July 2013). Student’s test and Cox’s regression have been performed. Since the creation of this unit, its activity has been growing by 30% in the first year and 10%, in the second. 421 patients with less than 40% left ventricular ejection fraction (LVEF) have been included; 181 had been treated before May 2011 while 240 were news patients treated during the study. Average age was 57±14 years old and average LVEF was 28%±7%. Therapeutics drugs cover was good compared to previous studies: 98% of patients has been treated by beta blockers, 94% by an antagonist of reninangiotensin-aldosteron system and 82% by an antagonist of mineralocorticoid receptor. Survival after 3 years of treatment was 87.5%. Re-admission rate was less than one readmission per patient and per year. No diagnosis parameter was a prognosis factor. But after 6 months of treatment, univariate analysis found significant prognosis factors of survival: dyspnea I-II, 6 minutes walking test >300m, BNP<400ng/ml (p<0,001). In multivariate analysis only BNP<400ng/ml at 6 months was associated with survival (p=0,012). Heart failure management unit in Bordeaux is conformed to European guidelines. Ambulatory sector is a good solution to cope with increasing activity. The most predictive factor of survival in our unit experience was evaluation at 6 months after diagnosis (like BNP<400ng/ml).