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Title: Meaningful management of heart failure at Epworth.
Authors: Morgan, Felicity
Zimmet, Hendrik
Harjit Singh, R.
Keywords: Victorian Cardiac Outcomes Registry
Acute Decompensating Heart Failure
Minimum Dataset
Epidemiological Data
Transitional Care
In-Patient Care
Discharge Planning
Out-Patient Care
Utilisation of Resources
Hospitalization Episodes
Baseline Data
Admission Treatment
Discharge Status
IV Diuretics
ACE Inhibitors
Beta Blockers
Cardiac Rehabilitation
Inpatient Mortality
Readmission Rate
Formalised Heart Failure Clinic
Cardiac Sciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2017
Citation: Epworth Research Institute Research Week 2017; Poster 30: pp 54
Conference Name: Epworth Research Institute Research Week 2017
Conference Location: Epworth Research Institute, Victoria, Australia
Abstract: BACKGROUND: In 2014 Victorian Cardiac Outcomes Registry (VCOR) piloted a project to develop a minimum dataset for use in patients presenting to 16 hospitals with acute decompensating heart failure (ADHF). In 2016 Epworth was the only private hospital to be invited to participate in a one month snapshot of patients with a purpose of collecting epidemiological data covering pre-admission, admission and post discharge transitional care. It aimed to identify current, specific issues of in-patient care, discharge planning and appropriate out-patient care in order to optimize the utilization of resources. 'Given that two thirds of the costs of managing heart failure relate to hospitalization episodes, considerable effort has been made to detect deterioration in clinical status early to prevent need for hospitalization' (Acute HF Data Definitions, VCOR, version 1.2, page 7). RESULTS: At Epworth Richmond 36 patients were identified (4th out of 16 in enrollment numbers). All patients were given the choice of opting out from the snapshot. Baseline data, admission treatment and discharge status was then collected. Follow up of all registered participants was completed 30 days post discharge. At Epworth, 58.3% of participants were admitted, through ED, treated by cardiologists, with nearly all having a history of HF. 66.7% were previously hospitalized and were an older average population than the cohort. The results indicated there was a high use of IV diuretics, appropriate use of inotropes, low use of ACE inhibitors on admission (which increased by discharge) and underutilization of beta blockers. Only 2.7% of patients were discharge to a heart failure specific outpatient program with only 11.1% going to cardiac (non-HF specific) rehabilitation. Inpatient mortality was 11.1% and 30 day readmission rate was 5.6%. CONCLUSION: The results indicates the need for a formalized heart failure clinic to maximize HF patient outcomes and minimize the need for hospitalization through better education and in-community management.
Type: Conference Poster
Affiliated Organisations: Monash Centre of Cardiovascular Research and Education in Therapeutics, Monash University
Type of Clinical Study or Trial: Prospective Study
Appears in Collections:Cardiac Sciences
Research Week

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