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Am J Public Health. 1997 Apr;87(4):643-8.

Factors contributing to the hospitalization of patients with congestive heart failure.

Author information

1
Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA.

Abstract

OBJECTIVES:

This study identifies acute precipitants of hospitalization and evaluates utilization of angiotension-converting enzyme inhibitors in patients admitted with congestive heart failure.

METHODS:

Cross-sectional chart-review study was done of 435 patients admitted nonelectively from February 1993 to February 1994 to an urban university hospital with a complaint of shortness of breath or fatigue and evidence of congestive heart failure.

RESULTS:

The most common identifiable abnormalities associated with clinical deterioration prior to admission were acute anginal chest pain (33%), respiratory infection (16%), uncontrolled hypertension with initial systolic blood pressure > or = 180 mm Hg (15%), atrial arrhythmia with heart rate > or = 120 (8%), and noncompliance with medications (15%) or diet (6%); in 34% of patients, no clear cause could be identified. After exclusion of those who were already on a different vasodilator or who had relative contraindications, 18 (32%) of the patients with ejection fractions < or = 0.35 measured prior to admission were not taking an angiotensin-converting enzyme inhibitor on presentation to the hospital.

CONCLUSIONS:

Interventions to improve compliance, the control of hypertension, and the appropriate use of angiotensin-converting enzyme inhibitors may prevent many hospitalizations of heart-failure patients.

PMID:
9146445
PMCID:
PMC1380846
DOI:
10.2105/ajph.87.4.643
[Indexed for MEDLINE]
Free PMC Article

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