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Heart failure patients twice as likely to die if admitted to general wards
Date:1/17/2011

Heart failure patients admitted to general wards are twice as likely to die as those admitted to cardiology wards, shows a national audit of the treatment of the condition, published online in the journal Heart.

Women fared worse than men when it comes to appropriate investigations and treatment, the findings suggest, although death rates were similar.

In 2006/7, heart failure accounted for more than a quarter of a million hospital deaths and discharges in England and Wales, equating to around 2.5 million bed days a year and at an annual cost to the NHS of 563 million.

The authors draw their conclusions from a survey of the first 10 patients admitted each month with a primary diagnosis of heart failure to 86 hospitals across England and Wales between April 2008 and March 2009.

During this period, just over 6,000 patients, with an average age of 78, were admitted with the condition. Almost half of these (43%) were women.

At admission, less than a third (30%) were reported to be breathless at rest and under half (43%) as having swollen feet/ankles. These are both diagnostic features of heart failure.

Appropriate investigations were not always carried out, the survey shows, with those admitted to general medical wards less likely to receive these than those admitted to cardiology wards.

Most patients (75%) were given a heart trace monitor test (echocardiogram). But only two thirds of those (65%) admitted to general medical wards were given this test.

This showed that the left ventricular ejection fraction (LVEF), an indicator of the pump action of one of the two lower chambers of the heart, was 40% or less in most of those admitted.

But LVEF was not recorded in one in four patients. And those with an LVEF of under 40% or in whom LVEF was not recorded were more likely to be women, older, and managed on general medical wards.

Levels of natriuretic peptides, which are a
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Contact: Emma Dickinson
edickinson@bmjgroup.com
44-020-738-36529
BMJ-British Medical Journal
Source:Eurekalert

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