BACKGROUND: Acutely decompensated heart failure/pulmonary edema is one of the most common medical problems in clinical practice. Approximately 500 patients are admitted to Rambam Health Care Campus yearly with the diagnosis of ADHF/PE. As a result, Rambam established local instructions and guidelines for the treatment of ADHF/PE based on the guidelines published by the American Heart Association, American College of Cardiology and The European Society of Cardiology. OBJECTIVE: To examine whether adherence to guidelines improves the outcome of patients with ADHF/PE in internal medicine wards. METHODS: Data were collected from the charts of 78 patients admitted to Rambam with ADHF/PE and were compared to a matched historic cohort. RESULTS: Echocardiography was performed more commonly in the study group patients as compared to the control group, 85% vs. 37.7% respectively (P = 0.0001). In patients who were treated according to the guidelines, angiotensin-converting enzyme inhibitors and beta-blockers were prescribed more commonly as compared to the control group. The 3 month mortality rate was significantly lower in the study group (P = 0.021). CONCLUSIONS: Adherence to guidelines for treatment of ADHF/PE decreased the short-term mortality and increased the use of medications known to reduce mortality and morbidity in patients with systolic heart failure. Echocardiography is an important tool to guide treatment of ADHF/PE.
BACKGROUND: Acutely decompensated heart failure/pulmonary edema is one of the most common medical problems in clinical practice. Approximately 500 patients are admitted to Rambam Health Care Campus yearly with the diagnosis of ADHF/PE. As a result, Rambam established local instructions and guidelines for the treatment of ADHF/PE based on the guidelines published by the American Heart Association, American College of Cardiology and The European Society of Cardiology. OBJECTIVE: To examine whether adherence to guidelines improves the outcome of patients with ADHF/PE in internal medicine wards. METHODS: Data were collected from the charts of 78 patients admitted to Rambam with ADHF/PE and were compared to a matched historic cohort. RESULTS: Echocardiography was performed more commonly in the study group patients as compared to the control group, 85% vs. 37.7% respectively (P = 0.0001). In patients who were treated according to the guidelines, angiotensin-converting enzyme inhibitors and beta-blockers were prescribed more commonly as compared to the control group. The 3 month mortality rate was significantly lower in the study group (P = 0.021). CONCLUSIONS: Adherence to guidelines for treatment of ADHF/PE decreased the short-term mortality and increased the use of medications known to reduce mortality and morbidity in patients with systolic heart failure. Echocardiography is an important tool to guide treatment of ADHF/PE.
Authors: Modele O Ogunniyi; James B Holt; Janet B Croft; Isaac A Nwaise; Henry E Okafor; Douglas B Sawyer; Wayne H Giles; George A Mensah Journal: Am J Med Sci Date: 2012-01 Impact factor: 2.378
Authors: Sana Shoukat; Saqib A Gowani; Ather M Taqui; Rameez Ul Hassan; Zain A Bhutta; Anum I Malik; Sajjad A Sherjeel; Quratulanne Sheheryar; Sajid H Dhakam Journal: BMC Cardiovasc Disord Date: 2011-11-17 Impact factor: 2.298