Re-hospitalizações e morte por insuficiência cardíaca: índices ainda alarmantes

Abstract

HF remains a condition associated with high mortality and high hospital readmission rates. At the end of the first year, 44.5% of these patients had not needed to visit the ER or had died, which indicates that we should provide HF patients with the best possible care in an attempt to change the natural course of this increasingly frequent syndrome.

Mortalidade por insuficiência cardíaca: análise ampliada e tendência temporal em três estados do Brasil

“…The same has been observed with in-hospital mortality rates due to HF. It is believed that this behavior can be explained by the advances attained in the last years regarding the HF approach, such as earlier diagnoses, more aggressive management during hospitalizations due to decompensations and the broader use of angiotensinconverting enzyme inhibitors and beta-blockers 21,22 .…”

É necessário suspender o betabloqueador na insuficiência cardíaca descompensada com baixo débito?

“…Dividing our cases according to the stratification of ADHERE study and comparing the two cohorts, we observe that our population is generally more severe than that which participated in ADHERE registry, because 74.9% of patients hospitalized in our hospital with systolic pressure below 115 mmHg, while in ADHERE registry only 18.5% were hypertensives 12,16 . Thus, our greatest severity is one of the explanation for longer periods of hospitalization and need for inotropic.…”

“…The natural history of heart failure, a disease with features of malignancy, has been modified with modern treatment 2,12 . Betablockers, through the reversal of cardiac remodeling, improve the quality of life, are important in reducing mortality and have been identified as the main drug for controlling HF 2-4 .…”

“…Patients with HF who did not compensate or not improved with treatment administered in the Emergency Room of Instituto do Coração were hospitalized in our institution, with the selection of the most severe patients 12 . This sample was consisted of patients in functional class IV signs of pulmonary and systemic congestion and signs of low cardiac output.…”

“…In a previous study, we compared the profile of our patients with those described in American ADHERE registry 12,16 . Dividing our cases according to the stratification of ADHERE study and comparing the two cohorts, we observe that our population is generally more severe than that which participated in ADHERE registry, because 74.9% of patients hospitalized in our hospital with systolic pressure below 115 mmHg, while in ADHERE registry only 18.5% were hypertensives 12,16 .…”