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Adherence to guidelines improves the clinical outcome of patients with acutely decompensated heart failure Braun E; Landsman K; Zuckerman R; Berger G; Meilik A; Azzam ZSIsr Med Assoc J 2009[Jun]; 11 (6): 348-53BACKGROUND: 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.|Adrenergic beta-Antagonists/therapeutic use[MESH]|Aged[MESH]|Angiotensin-Converting Enzyme Inhibitors/therapeutic use[MESH]|Cohort Studies[MESH]|Female[MESH]|Guideline Adherence/*statistics & numerical data[MESH]|Heart Failure/complications/diagnostic imaging/*drug therapy/mortality[MESH]|Humans[MESH]|Male[MESH]|Prospective Studies[MESH]|Pulmonary Edema/diagnostic imaging/drug therapy/etiology/mortality[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH]|Ultrasonography[MESH] |
