PMID- 11688347
OWN - NLM
STAT- MEDLINE
DCOM- 20020627
LR  - 20071115
IS  - 0393-9340 (Print)
IS  - 0393-9340 (Linking)
VI  - 16
IP  - 1
DP  - 2001 Jan-Mar
TI  - [Treatment of heart failure at a hospital in the north-east of Italy].
PG  - 26-31
AB  - Because the number of patients who require hospitalization for heart failure is 
      increasing, their treatment is often entrusted to physicians operating in 
      Departments of General Medicine. Published data on the in-hospital treatment of 
      heart failure in Italy have not been available up to now, as they are limited 
      only to patients admitted to Department of Cardiology. This study concerns the 
      patients who were discharged from our Hospital after a diagnosis of heart failure 
      (International Classification of Disease--9th Edition, code 428) from January 1 
      to February 28, 1998. Information collected from patient hospital records 
      included: age, sex, department to which the patient was referred (General 
      Medicine or Cardiology), cause of heart failure, New York Heart Association 
      (NYHA) functional class, symptoms and signs of heart failure, therapy, length of 
      hospitalization and in-hospital mortality. Of the 178 patients identified (82 
      males--46.1%, 96 females--53.9%, mean age 78 +/- 11 years) 163 (91.6%) were 
      referred to Departments of General Medicine. The cause of heart failure was 
      coronary artery disease in 88 (49.4%) patients, arterial hypertension in 40 
      (22.4%), primary cardiomyopathy in 28 (15.7%), valvular heart disease in 22 
      (12.3%). NYHA functional class was reported or deducible from the severity of 
      dyspnea in 57 (32%) patients. In 8 (4.6%) patients symptoms or signs of heart 
      failure were not reported. Chest X-ray was performed in 77.6% of cases, 
      echocardiography in 41%, ambulatory electrocardiography in 10% and coronary 
      arteriography in 5%. Left ventricular ejection fraction was known in 90 (51.6%) 
      patients, in 44 (48.9%) of these it was > or = 45%. ACE-inhibitors were used in 
      99 (55.6%) patients, but this percentage rose to 63% when considering only 
      patients with left ventricular ejection fraction < 45%. Eighty-five patients were 
      treated with captopril or enalapril; in 52 patients (61.4%) the daily dose of 
      captopril was < 75 mg and that of enalapril was < 20 mg. Diuretics were utilized 
      in 155 (87%) patients, digoxin in 123 (69%), beta-blocker agents in 5 (2.8%) and 
      other vasodilators in 95 (53%). The mean length of hospitalization was 13 +/- 9 
      days and the overall in-hospital mortality was 18%. In conclusion, the results of 
      this study demonstrate that the patients who are discharged from our hospital 
      with a diagnosis of heart failure are, on the average, very old. The vast 
      majority of these patients are admitted to the Departments of General Medicine. 
      The advanced age of our patients can explain the limited use of ACE-inhibitors 
      and, especially, of beta-blockers.
FAU - Buttignoni, S C
AU  - Buttignoni SC
AD  - Divisione di Cardiologia, Dipartimento di Medicina Clinica e Sperimentale, 
      Universita degli Studi di Padova.
FAU - Crosato, M
AU  - Crosato M
FAU - Boffa, G M
AU  - Boffa GM
LA  - ita
PT  - English Abstract
PT  - Journal Article
TT  - Il trattamento dello scompenso cardiaco in un'Azienda Ospedaliera del Nord-Est.
PL  - Italy
TA  - Ann Ital Med Int
JT  - Annali italiani di medicina interna : organo ufficiale della Societa italiana di 
      medicina interna
JID - 8806705
SB  - IM
MH  - Aged
MH  - Female
MH  - Heart Failure/*therapy
MH  - Hospitals
MH  - Humans
MH  - Italy
MH  - Male
EDAT- 2001/11/02 10:00
MHDA- 2002/06/28 10:01
CRDT- 2001/11/02 10:00
PHST- 2001/11/02 10:00 [pubmed]
PHST- 2002/06/28 10:01 [medline]
PHST- 2001/11/02 10:00 [entrez]
PST - ppublish
SO  - Ann Ital Med Int. 2001 Jan-Mar;16(1):26-31.