Heart failure outcomes improving

Over just 3 years, there have been substantial improvements in the outcomes of patients hospitalized with heart failure and more and more doctors are now following recommended treatment guidelines, according to a report in the American Heart Journal.

"Efforts to improve the quality of care of patients hospitalized with heart failure are paying off," Dr. Gregg C. Fonarow told Reuters Health.

"Increased use of certain beneficial heart failure medications and marked reductions in medications that have failed to improve or may even worsen outcome have translated into substantially lower risk of death and serious complications during hospitalization for heart failure," he commented.

Fonarow, from the Ahmanson-UCLA Cardiomyopathy Center, Los Angeles, and colleagues examined trends in the characteristics and outcomes of nearly 160,000 patients hospitalized for heart failure between 2002 and 2004.

The results showed that heart failure severity remained steady during the study period, yet patient outcomes improved. Specifically, death rates for hospitalized patients fell from 4.5 to 3.2 percent, which may not seem like much, but at the population level is huge because heart failure is so common.

In addition, by the end of the study period, patients were less likely to require a ventilator for breathing assistance and were less likely to be admitted to the intensive care unit.

Coinciding with these changes was an increase in use of medications known to have a beneficial effect.

"If similar improvements to those observed in (the present study) had occurred at hospitals nationwide, this would translate to 14,300 fewer in-hospital deaths and 880,000 costly hospital days eliminated per year," Fonarow said.

"Despite these substantial improvements, there remain further opportunities to improve the quality of care and outcomes for this important, high-risk patient population," Fonarow pointed out. "These findings highlight the need for further efforts to accelerate improvements in the care of patients hospitalized with heart failure."

SOURCE: American Heart Journal, April 20th online issue, 2007.