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.