BACKGROUND For patients with acute heart failure (HF), specialist HF care during admission improves diagnosis and treatments. OBJECTIVES The authors aimed to investigate the association of HF specialist care with in-hospital and longer term prognosis. METHODS The authors used data from the National Heart Failure Audit from January 1, 2018, to December 31, 2022, linked to electronic records for hospitalization and deaths. All-cause mortality was the primary outcome measure and in-hospital mortality the secondary outcome measure. RESULTS Data for 227,170 patients admitted to hospital with HF (median age: 81 years; IQR: 72-88 years), were analyzed. Approximately 80% of acute HF admissions received support from HF specialists. Thirty-nine percent of patients (n = 70,720) were seen by a multidisciplinary team (HF physicians and HF specialist nurses [HFSNd]), 22% (n = 40,330) were seen by HFSNs alone, and the remaining 39% (n = 71,700) were seen exclusively by specialist HF physicians. At discharge, more patients who received HF specialist care were prescribed medical therapy for HF and had specialized follow-up. Conversely, diuretic agents were prescribed to fewer patients. HF specialist care was independently associated with a higher rate of prescribing HF therapies at discharge and a lower likelihood of receiving diuretic therapy (OR: 0.90 [95% CI: 0.86-0.95]; P < 0.001). HF specialist care was associated with better long-term survival (HR: 0.89 [95% CI: 0.87-0.90]; P < 0.001) and lower in-hospital mortality (OR: 0.92 [95% CI: 0.0.88-0.97]; P < 0.001). CONCLUSIONS Receiving HF specialist care during admission for HF is associated with a higher rate of implementation of medical therapy, fewer discharges on diuretic therapy, and lower in-hospital and long-term mortality across the left ventricular ejection fraction spectrum, especially for patients with heart failure with reduced ejection fraction.

中文翻译：

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因急性心力衰竭入院的患者的心力衰竭专科护理和长期结果。


背景 对于急性心力衰竭 (HF) 患者，入院期间的专业心力衰竭护理可改善诊断和治疗。目的 作者旨在调查心力衰竭专科护理与院内和长期预后的关系。方法 作者使用了 2018 年 1 月 1 日至 2022 年 12 月 31 日国家心力衰竭审计的数据，并与住院和死亡的电子记录相关联。全因死亡率是主要结局指标，院内死亡率是次要结局指标。结果 对 227,170 名因心力衰竭入院的患者（中位年龄：81 岁；IQR：72-88 岁）的数据进行了分析。大约 80% 的急性心力衰竭入院患者得到了心力衰竭专家的支持。 39% 的患者 (n = 70,720) 由​​多学科团队（心力衰竭医生和心力衰竭专科护士 [HFSNd]）就诊，22% (n = 40,330) 仅由 HFSN 就诊，其余 39% (n = 71,700）仅由心力衰竭专科医生就诊。出院时，更多接受心衰专科护理的患者接受了心衰药物治疗并进行了专门随访。相反，利尿剂的使用对象较少。心力衰竭专科护理与出院时较高的心力衰竭治疗率和较低的接受利尿治疗的可能性独立相关（OR：0.90 [95% CI：0.86-0.95]；P < 0.001）。心力衰竭专科护理与更好的长期生存率（HR：0.89 [95% CI：0.87-0.90]；P < 0.001）和较低的院内死亡率（OR：0.92 [95% CI：0.0.88-0.97]）相关;P<0.001）。 结论 因心力衰竭入院期间接受心力衰竭专科护理与较高的药物治疗实施率、较少的利尿治疗出院率以及较低的左心室射血分数谱系住院死亡率和长期死亡率相关，特别是对于心脏病患者射血分数降低的失败。