166 Single Centre Experience with Heart Function Clinic and Heart Failure Admissions

Abstract

Heart failure admissions contribute significantly to health care expenditure. Multidisciplinary heart failure clinic (HFC) may reduce readmission rate and mortality. We conducted a retrospective audit of heart failure admissions under the Cardiology Service in 2018. 178 of 198 admitted patients were analysed. Baseline characteristics: male 67.4%, average age 72.6y. Co-morbidities: ischaemic heart disease (47.4%), atrial fibrillation (50.9%), diabetes (37.1%), hypertension (64.6%), lung pathology (27.4%) and chronic kidney disease (43.4%). Heart failure with preserved ejection fraction (HFpEF) accounted for 30.9% and heart failure with reduced ejection fraction (HFrEF) accounted for 60.5% of patients. HFpEF patients were older than HFrEF patients (76.3 vs 70.5y, p=0.01). HFpEF were less likely to attend HFC (38.9% of all HFpEF patients), compared with 50.9% of all HFrEF patients attending HFC. Length of stay (LOS) for index admission was similar in both groups (4.1 vs 4.3 days in HFpEF and HFrEF respectively). There was no difference in median total admissions over 12 months between the groups. Patients attending HFC had numerically increased median LOS during index admission (6.0 vs 4.9 days, p=0.07). There was a trend towards increased severity of HFrEF patients attending HFC. The burden of HFpEF on inpatient services are similar to those of HFrEF, with no difference in median LOS or admission rate. Despite this, they are under-represented in HFC. Increased LOS in patients attending HFC likely represents referral bias of unwell patients with severe HFrEF.