SHA 021. Adult congenital heart diseases, nursing care: Present and future challenges

Abstract

shown to reduce readmissions and improve medication adherence rates. However, its impact on survival is not well demonstrated. The aim of this study is to evaluate the impact of a nurse-led HF clinic on all cause mortality. Methods: We included 425 consecutive patients who were admitted with HF exacerbations in 2008 and 2009. All patients were invited to follow-up in a nurse led HF clinic; 199 (48%) patients agreed. All patients were followed up for all cause mortality which was confirmed by national death index. The independent predictors of outcomes were identified using multivariable Cox regression. Results: The 199 patients who agreed to follow up in the HF clinic were younger, more often men and had lower ejection fraction, BUN and systolic blood pressure. After a median follow-up of 15 months (range 6–30 months), 55 patients died; 14 patients in the clinic group (7%) compared to 41 patients (19%) in the regular care group. Using multivariable Cox regression, the participation in the HF clinic was independently associated with two and a half folds reduction in all cause mortality (HR 0.4, 95% CI 0.2–0.8, p= 0.008). Conclusions: Nurse led HF clinic is independently associated with improved survival among patients with decompensated heart failure.