Treatment of in-hospital cardiac patients is focus of Jefferson University presentations

ne Adams, R.N., MPH; Jocelyn Andrel, Paul Mather, M.D.,

Sharon Rubin, M.D. and David Whellan, M.D.

Beta Blocker Dose Adjustment upon Hospitalization for Acute Decompensated Heart Failure.
(Embargoed for release 9 am, Tuesday, March 27; Abstract #1028-66)

When a patient with chronic heart failure is admitted to the hospital, it is likely that she or he is already on a beta blocker therapy. Yet the role of these medications in the patients length of stay (LOS) as well as a treatment for her or his condition remains unclear.

To clarify the situation, researchers at Jefferson Medical College conducted a retrospective study of patients who were admitted to Thomas Jefferson University Hospital with severe heart failure (ADHF) in 2004 and 2005 and who were on outpatient beta blocker therapy.

They found:

  • Blood pressure was a significant predictor of beta blocker dose reduction or cessation.
  • Patients whose beta blocker dose was reduced or stopped had a significantly increased LOS.
  • Patients who were admitted to the Family Medicine service were more likely to have their beta blocker stopped or decreased than those who were admitted to the Cardiology service.

In conducting the research, the daily outpatient dosage was compared to the inpatient dose on the first day of admission and analyzed for numerous associations including dosage changes admitting specialty and LOS.

Of 464 patients, 84 percent were continued on a beta blocker during the first day of their hospitalization. Most--96 percent--were continued on their outpatient dosage. In those cases where the beta blocker remained the same, 41 percent had dose decrease, 50 percent continued their outpatient dose and nine percent had their dose increased.

The researchers suggest that physicians who are caring for hospitalized chronic heart failure patients who are already on a

Contact: Nan Myers
Thomas Jefferson University

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