Heart failure exacerbation leading to hospital admission: a cross-sectional study

Objectives: The aim of this pilot study was to investigate cause(s) of heart failure (HF). Setting: The emergency department and medical wards at Malmö University Hospital. Method: A cross sectional pilot study. Main outcome measures: Comparison of compliance, comprehension and optimal treatment on a population basis between men and women, younger (≤75 years) and elderly (>75 years) patients, and patients in different New York Heart Association (NYHA) classes, in order to assess if exacerbation could have been caused by any of these factors. Results: Of the 47 patients included, 60% reported high compliance, with significant differences between women and men, and between patients in NYHA class IV and patients in NYHA class III. Comprehension on self-care was poor. Only 30% weighed themselves regularly and 45% did not limit the amount of fluids. No more than 28% reported they would contact a health professional in the case of experiencing more symptoms. Suboptimal treatment was also found to be a great concern. The majority were treated with recommended agents, but had not achieved target dose as recommended in the guidelines. Conclusion: This pilot study indicates suboptimal HF management of patients with HF prior to hospital admission due to HF exacerbation. A larger study is needed to assess the extent of the problem, and establish the need and nature of management improvement in different patient subgroups.