Patients with worsening chronic heart failure require hospital care - listen to the patient

• Main Authors: Patel, Harshida, Shafazand, Masoud, Ekman, Inger, Swedberg, Karl, Schaufelberger, Maria
• Format: Conference Proceeding
• Language: English
• Subjects: Cardiac and Cardiovascular Systems; Chronic heart failure; Health Care Service and Management, Health Policy and Services and Health Economy; hospital care; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Kardiologi; Nursing; Omvårdnad; symptoms
• ISSN: 1474-5151

Background: Chronic heart failure (CHF) is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. Aim: To characterise patients with CHF that seek an emergency department (ED) because of their deteriorating condition and to explore the reasons why they are admitted to hospital. Method: Patients (n = 2648) seeking care for dyspnoea were identified at the ED. Of these 2648 patients, 1127 had a previous diagnosis of CHF, and of these, 785 were included in the present study with at least one sign and one symptom of worsening CHF. Results: Only 2% of the patients could be sent home directly from the ED. The remaining patients were admitted to hospital because of serious conditions, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion: The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of comorbidities. Patients with severe chronic illness like CHF with symptomatic deterioration could be attended with focus on symptom relieve and without additional emergency room investigations before hospital admission.