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Isr Med Assoc J. 2009 Jun;11(6):348-53.

Adherence to guidelines improves the clinical outcome of patients with acutely decompensated heart failure.

Author information

1
Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel. e_braun@rambam.health.gov.il

Abstract

BACKGROUND:

Acutely decompensated heart failure/pulmonary edema is one of the most common medical problems in clinical practice. Approximately 500 patients are admitted to Rambam Health Care Campus yearly with the diagnosis of ADHF/PE. As a result, Rambam established local instructions and guidelines for the treatment of ADHF/PE based on the guidelines published by the American Heart Association, American College of Cardiology and The European Society of Cardiology.

OBJECTIVE:

To examine whether adherence to guidelines improves the outcome of patients with ADHF/PE in internal medicine wards.

METHODS:

Data were collected from the charts of 78 patients admitted to Rambam with ADHF/PE and were compared to a matched historic cohort.

RESULTS:

Echocardiography was performed more commonly in the study group patients as compared to the control group, 85% vs. 37.7% respectively (P = 0.0001). In patients who were treated according to the guidelines, angiotensin-converting enzyme inhibitors and beta-blockers were prescribed more commonly as compared to the control group. The 3 month mortality rate was significantly lower in the study group (P = 0.021).

CONCLUSIONS:

Adherence to guidelines for treatment of ADHF/PE decreased the short-term mortality and increased the use of medications known to reduce mortality and morbidity in patients with systolic heart failure. Echocardiography is an important tool to guide treatment of ADHF/PE.

PMID:
19697585
[Indexed for MEDLINE]
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