Morbidity and mortality in elderly patients with heart failure managed with a comprehensive care model vs. usual care: The UMIPIC program

González-Franco, Álvaro; González, J.M. Cerqueiro; Arévalo‐Lorido, J.C.; Álvarez-Rocha, P.; Carrascosa-García, Sara; Armengou, Arola; Guzmán-García, M.; Trullàs, Joan Carles; Montero-Pérez-Barquero, Manuel; Manzano, Luís

doi:10.1016/j.rceng.2021.05.007

Cited by 6 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of them have HFpEF (>50%). This profile is similar to the one identified in other studies developed in Spain and different HF units [ 14 , 16 , 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 88%

“…The following paper presents a study carried out in a Heart Failure Unit, included in the UMIPIC program of the Spanish Society of Internal Medicine, based on the comprehensive care of elderly patients with HF and other comorbidities [ 14 , 15 , 16 ]. This program, made for managing patients with HF and other comorbidities, is extended throughout Spain.…”

Section: Introductionmentioning

confidence: 99%

“…A model for the management of chronic patients with HF is proposed, centered on three main aspects: the education of basic concepts involving the patient and their relatives in their disease, the comprehensive assessment of this type of patient, and the continuity of care in coordination with primary healthcare level. Its general objectives are to reduce the rate of readmissions and visits to the Emergency Department, reduce the number of visits to other specialties, reduce morbidity and mortality, and improve patients’ quality of life [ 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

et al. 2022

View full text Add to dashboard Cite

(1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need for palliative care. This study aims to identify palliative care needs in HF patients and describe clinical features related to short-term mortality. (2) Methods: A descriptive, observational, cross-sectional, and retrospective study was carried out in an HF unit of a Spanish tertiary hospital. Patients’ socio-demographic and clinical data were collected from clinical records, and different instruments were used to establish mortality risks and patients’ needs for palliative care. Subsequently, univariate and bivariate descriptive analyses were performed. A binary logistic regression model helped to determine variables that could influence mortality 12 months after admission to the Unit. (3) Results: The studied population, sixty-five percent women, had an average age of 83.27 years. Among other clinical characteristics predominated preserved ejection fraction (pEF) and dyspnea NYHA (New York Heart Association) class II. The most prevalent comorbidities were hypertension and coronary heart disease. Forty-nine percent had a low–intermediate mortality risk in the following year, according to the PROFUND index. The NECPAL CCOMS-ICO© instrument identified subjects who meet the criteria for palliative care. This predictive model identified NECPAL CCOMS-ICO© results, using beta-blockers (BB) or AIIRA (Angiotensin II receptor antagonists) and low glomerular filtration rate (GFR) as explanatory variables of patients’ mortality in the following year. (4) Conclusions: The analysis of the characteristics of the population with HF allows us to identify patients in need of palliative care. The NECPAL CCOMS-ICO© instrument and the PROFUND have helped identify the characteristics of people with HF who would benefit from palliative management.

show abstract

“…Most of them have HFpEF (>50%). This profile is similar to the one identified in other studies developed in Spain and different HF units [ 14 , 16 , 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

et al. 2022

View full text Add to dashboard Cite

show abstract

“…This finding seems relevant to us in the sense that many decompensations are treated as outpatients, thus preventing the patient from going to the emergency room and ending up being admitted to hospital. However, we found a greater proportion of patients with left ventricular systolic dysfunction compared with the UMIPIC population [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…A sample size of 152 patients was estimated (76 patients in each arm). Based on previous Spanish studies [ 26 ], we considered an incidence of 43% for the combined variable in the SOC group versus 20% in the LUS-guided treatment group with a statistical power of 90% (ß = 0.10), an expected drop-out rate of 10% and a level of significance ∞ = 0.05 bilaterally.…”

Section: Methodsmentioning

confidence: 99%

The Effects of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Results from the EPICC Randomized Controlled Trial

Torres‐Macho

González

Arévalo-Lorido

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Pulmonary congestion (PC) is associated with an increased risk of hospitalization and death in patients with heart failure (HF). Lung ultrasound is highly sensitive for detecting PC. The aim of this study is to evaluate whether lung ultrasound-guided therapy improves 6-month outcomes in patients with HF. Methods: A randomized, multicenter, single-blind clinical trial in patients discharged after hospitalization for decompensated HF. Participants were assigned 1:1 to receive treatment guided according to the presence of lung ultrasound signs of congestion (semi-quantitative evaluation of B lines and the presence of pleural effusion) versus standard of care (SOC). The primary endpoint was the combination of cardiovascular death, readmission, or emergency department or day hospital visit due to worsening HF at 6 months. In September 2020, after an interim analysis, patient recruitment was stopped. Results: A total of 79 patients were randomized (mean age 81.2 +/− 9 years) and 41 patients (51.8%) showed a left ventricular ejection fraction >50%. The primary endpoint occurred in 11 patients (29.7%) in the SOC group and in 11 patients (26.1%) in the LUS group (log-rank = 0.83). Regarding nonserious adverse events, no significant differences were found. Conclusions: LUS-guided diuretic therapy after hospital discharge due to ADHF did not show any benefit in survival or a need for intravenous diuretics compared with SOC.

show abstract

Peritoneal ultrafiltration in older adult patients with advanced heart failure

Rodríguez-Álvarez,

Piñeiro-Fernández,

Guerrero-Sande

et al. 2023

Intern Emerg Med

View full text Add to dashboard Cite

Morbidity and mortality in elderly patients with heart failure managed with a comprehensive care model vs. usual care: The UMIPIC program

Cited by 6 publications

References 33 publications

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

The Effects of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Results from the EPICC Randomized Controlled Trial

Peritoneal ultrafiltration in older adult patients with advanced heart failure

Contact Info

Product

Resources

About