TREATMENT OUTCOME IN INTENSIVE HEART FAILURE CLINIC IN CHIANGRAI PRACHANUKROH HOSPITAL
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Abstract
BACKGROUND: Heart failure in Chiangrai province, is a high burden of disease. Many factors can contribute to heart failure deterioration such as loss to follow-up, medication nonadherence, lack of understanding of the disease, and caregiver problems. Due to these reasons, we established an intensive heart failure clinic at Chiangrai Prachanukroh Hospital.
OBJECTIVE: To evaluate the cardiovascular mortality rate at 12 months and compare the results of treatment before and after in an intensive heart failure clinic which is composed of rehospitalization due to heart failure, left ventricular ejection fraction (LVEF) and evaluate patients’ symptoms using 6-minute walk test.
METHODS: A retrospective cohort study in heart failure reduced LVEF at an intensive heart failure clinic, Chiangrai Prachanukroh hospital between July 2020 to December 2022 using analysis of mortality rates in 6 and 12 months, also comparing the results of one group prior to and after treatment using repetitive measurement analysis.
RESULTS: 67 patients were included whose cardiovascular mortality rates in 6 months and 12 months were 10.45% and 16.42%, respectively. The highest reason for inclusion in the clinic was a loss to follow-up or non-adherence to medication (85.07%).
The results of treatment before and after in an intensive heart failure clinic were significantly different. After treatment in clinic, the rate of rehospitalization from heart failure was decreased (26.8% V.S. 24.24%, p<0.001), mean LVEF and a 6-minute walk test result was improved (20.02 ± 6.86% V.S. 42.89 ± 14.73 %, p< 0.001 and 375.07 ±105.11 m. V.S. 444.42 ± 114.10 m., P<0.001 respectively).
Conclusion and recommendation: This intensive heart failure clinic composed of a multidisciplinary care team can reduce rehospitalization from heart failure, improved LVEF, and recover patients’ symptoms. However, possibly due to high-risk condition and previous treatment problems, so, we found the quite high mortality in 1 year. This study supports that the heart failure patients should be cared in heart failure clinic which is composed of a multidisciplinary care team.
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