"There is marked variation and a lack of structure in cardiovascular care in the nation's hospitals," said lead investigator Gregg C. Fonarow, M.D., the Eliot Corday Chair in Cardiovascular Medicine and Science at the University of California at Los Angeles.
"There is a lot more that can be done before heart failure patients leave the hospital to improve the quality of patients' lives and make sure they continue to do well."
Fonarow presented data on the first 33,046 patients enrolled in ADHERE, covering the period from its launch in September 2001 through January 2003.
ADHERE (Acute Decompensated Heart failurE national REgistry) is an ongoing observational registry of patients hospitalized with a primary diagnosis of acute heart failure. The registry includes 250 hospitals across the United States. About 100,000 patients from community, tertiary and academic institutions are enrolled.
The researchers assessed four quality of care indicators: 1) patients received a complete set of discharge instructions; 2) left ventricular function was measured (to determine the heart's pumping ability); 3) ACE-inhibitors were prescribed at discharge (unless the patient had a medical reason for not taking the drug); and 4) current smokers received smoking cessation counseling.
Participants were age 72 on average, 52 percent were female, and 59 percent had coronary artery disease. Their average hospital stay was 4.5 days, and 4.2 percent of the participants died in the hospital.
Thirty-one percent of ideal candidates for ACE-inhibitors were discharged without receiving this life-prolonging therapy; 72 percent were discharged without receiving a complete set of discharge ins
Contact: Carole Bullock
American Heart Association