P19 | Post-discharge follow-up in day hospital of patients with heart failure: hospital-territory integrated management
D. Biondi1, F. Rossi2, M. Mendeni2, M. Miclini2, S. Molinari3, M. Camoni2, R. Furloni2 | 1SS Day Hospital, Ospedale Vallecamonica, Esine (BS), 2SC Medicina Interna, Ospedale Vallecamonica, Esine (BS), 3SC Medicina Interna, Ospedale Vallecamonica, Esine (BS), Italy
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Premises and Purpose of the study: Heart failure constitutes a significant health problem given its high prevalence, the frequency of re-hospitalizations and severe disability, which often entail high social costs. The day-hospital for heart failure, allows the structuring of a rehabilitation project, at ensuring the multidisciplinary nature and continuity of care.
Materials and Methods: 160 patients with heart failure were admitted to a day hospital during 12/30/2022-12/31/2023 for follow-up, after hospitalization at our Internal Medicine Unit. Management was integrated with general practitioners, after conducting an initial evaluation both at discharge and 30 days later.
Results: Mean age 79.7±8.5; males (58.1%), females (41.2%). Hb:11,9±0.4; creatinine 1.4±0.3; CrCl 43.8±12.5; K. 4.0±0.8; SBP 122.3±; DBP 70.9±9.6; BMI 24.7±4.7. HFrEF 44.3% (EF% 35.5±2.5). HFmrEF 13.7% (EF% 46.4±2.1). HFpEF 43.1% (EF% 62.2±5.0); BNP at baseline and 30 days (551.3 vs. 271.9); NT-proBNP at baseline and 30 days (1352.9 vs. 853.2). Comorbidities: CAD (32.5), CKD (48.5%), COPD (27.5%), Anemia (40.3%), Diabetes (33.1%), Hypertension (62.5%), AF (35%). Treatment: ACE/ARNI (89.9%), BB (86.3%), MRA (48.5%), diuretics (87.5%), digitalis (12.5%), amiodarone (22.0%), NAO (33.6%)
Conclusions: A day hospital follow-up approach, after discharge, in patients with congestive heart failure, can improve long-term prognosis. The results, do not seem to depend on any adjustment of the drug. Natriuretic peptides (NPs) represent one potentially appealing strategy, to personalize the approach.
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