PMID- 21910370
OWN - NLM
STAT- MEDLINE
DCOM- 20111019
LR  - 20110913
IS  - 1565-1088 (Print)
VI  - 13
IP  - 8
DP  - 2011 Aug
TI  - Clinical outcome of patients with chronic heart failure followed in a specialized 
      heart failure center.
PG  - 468-73
AB  - BACKGROUND: Patients with heart failure (HF) have a poor prognosis. Heart failure 
      centers with specialized nurse-supervised management programs have been proposed 
      to improve prognosis. OBJECTIVES: To evaluate the clinical outcome of patients 
      with HF treated at a multidisciplinary HF center of Clalit Health Services in 
      Jerusalem in collaboration with Hadassah University Hospital. METHODS: We 
      evaluated clinical outcome including hospitalizations and death in all HF 
      patients followed at the HF center for 1 year. RESULTS: Altogether, 324 patients 
      were included and followed at the HF center; 58% were males with a mean age of 76 
      +/- 11 years, and 58% were in New York Heart Association (NYHA) functional class 
      Ill-IV. The overall 1 year survival rate was 91% and the 1 year hospitalization 
      rate 29%. Comparing patients in the HF center to the whole cohort of patients 
      with a diagnosis of HF (N = 6618) in Clalit Health Services in Jerusalem 
      demonstrated a similar 1 year survival rate: 91% vs. 89% respectively but with a 
      significantly reduced hospitalization rate: 29% vs. 42% respectively (P < 0.01). 
      Cox regression analysis demonstrated that treatment in the HF center was a 
      significant predictor of reduced hospitalization after adjustment for other 
      predictors (hazard ratio 0.65, 95% confidence interval 0.53-0.80, P < 0.0001). A 
      subset of patients that was evaluated (N = 78) showed significantly increased 
      compliance. NYHA class improved in these patients from a mean of 3.1 +/- 0.1 to 
      2.6 +/- 0.1 after treatment (P < 0.0001). CONCLUSIONS: Supervision by dedicated 
      specialized nurses in a HF center increased compliance, improved functional 
      capacity in HF patients, and reduced hospitalization rate. HF centers should be 
      considered part of the standard treatment of patients with symptomatic HF.
FAU - Gotsman, Israel
AU  - Gotsman I
AD  - Heart Institute, Hadassah University Hospital, Jerusalem, Israel. 
      igotsman@bezeqint.net
FAU - Zwas, Donna
AU  - Zwas D
FAU - Zemora, Zehava
AU  - Zemora Z
FAU - Jabara, Refat
AU  - Jabara R
FAU - Admon, Dan
AU  - Admon D
FAU - Lotan, Chaim
AU  - Lotan C
FAU - Keren, Andre
AU  - Keren A
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
RN  - 0 (Cardiotonic Agents)
SB  - IM
CIN - Isr Med Assoc J. 2011 Aug;13(8):494-5. PMID: 21910375
MH  - Aged
MH  - Cardiac Care Facilities/*organization & administration
MH  - Cardiotonic Agents/therapeutic use
MH  - *Continuity of Patient Care
MH  - Counseling
MH  - Diet
MH  - Female
MH  - Heart Failure/classification/*mortality/*therapy
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Israel
MH  - Male
MH  - Nursing Staff, Hospital
MH  - *Patient Care Team
MH  - Patient Compliance
MH  - Regression Analysis
MH  - Self Care
EDAT- 2011/09/14 06:00
MHDA- 2011/10/20 06:00
CRDT- 2011/09/14 06:00
PHST- 2011/09/14 06:00 [entrez]
PHST- 2011/09/14 06:00 [pubmed]
PHST- 2011/10/20 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2011 Aug;13(8):468-73.