Understanding Hospitalization in Patients with Heart Failure

Abstract

Heart failure is one of the most important and challenging public health problems of the 21 st century and is associated with hard outcomes, such as death and hospitalization. New treatments for heart failure, despite the decrease in mortality, have not contributed to the decrease in hospitalization rates. Patients admitted with heart failure have a high event rate (> 50%) with a mortality rate between 10 and 15% and a rehospitalization rate within 6 months after discharge of 30 to 40%. Three major causes seem to directly affect the rehospitalization of patients with heart failure: comorbidities, congestion and target-organ lesion. The transition from inpatient to outpatient is a period of vulnerability, due to the progressive nature complexity of heart failure, with an impact on prognosis and which can extend for up to 6 months after hospital discharge. The physician has an important role in the actions that can minimize the risk of hospitalization for heart failure and the multidisciplinary approach, associated with the implementation of good practices supported by scientific evidence, can reduce the risk of hospitalization. The use of routines that have been proven to reduce hospitalization should be used in Brazilian hospitals. The objective of this review was to discuss the main causes of hospitalization, their impact on heart failure evolution and strategies that can be used to reduce it.

Humanistic burden and economic impact of heart failure – a systematic review of the literature

“…This is often required owing to worsening of symptoms. The acute nature of these occurrences, along with the risk of infection, can mean that patients with HF may be admitted to hospital as an emergency case 18 , incurring high costs 19 . Patients are typically treated in the intensive care unit, with clinical stabilization and symptom improvement as the primary focus following admission 18 .…”

Predictors of Hospitalization for Heart Failure Decompensation in 18-months Follow-up After Index Hospitalization for Acute Heart Failure

“…Another problem is very high decompensation rate with a need of hospitalization, often very shortly after discharge–25% patients are readmitted within 1 month ( 2 ). Mesquita et al ( 3 ) reported that patients admitted with HF have a high event rate (>50%) with a mortality rate between 10 and 15% and a rehospitalization rate within 6 months after discharge of 30 to 40%. Cardiologists are trying to find initiatives to stop this negative trends.…”

Adesão De Pacientes Com Insuficiência Cardíaca À Terapêutica Instituída

“…No Brasil, a IC constitui-se na primeira causa de internação hospitalar em pacientes acima de 60 anos de idade, sendo associada a elevadas taxas de morbidade e mortalidade. Estima-se que 26 milhões de pessoas são portadoras de IC, e 2 milhões de novos casos são diagnosticados a cada ano no mundo (2) . Nesse contexto, torna-se essencial que as medidas de adesão à terapêutica instituída para IC sejam incorporadas à mudança de estilo de vida necessária para controle da doença.…”

“…Nesse contexto, torna-se essencial que as medidas de adesão à terapêutica instituída para IC sejam incorporadas à mudança de estilo de vida necessária para controle da doença. Com esse procedimento é possível alcançar a estabilidade clínica e a manutenção da capacidade funcional, além de reduzir os avanços no remodelamento cardíaco e desfechos clínicos desfavoráveis (1)(2) . A adesão terapêutica pode ser definida como a concordância entre o comportamento de um indivíduo e a orientação de um profissional de saúde.…”

“…Entre as não farmacológicas, destacam-se a restrição hidrossalina, prática regular de atividade física, verificação diária de peso, reconhecimento precoce de sinais e sintomas de descompensação e uso correto da terapia farmacológica (4) . Evidências na literatura apontam que pacientes com IC têm redução na qualidade de vida em virtude da não adesão às recomendações terapêuticas (2,(5)(6) . Portanto, cabe ao enfermeiro, juntamente com a equipe multidisciplinar e a família do paciente, planejar/executar estratégias que visem melhorar a adesão e, por conseguinte, a qualidade de vida dessa população de risco.…”