1. First symptoms and health care pathways in hospitalized patients with acute heart failure: <scp>ICPS2</scp> survey. A report from the Heart Failure Working Group (GICC) of the French Society of Cardiology
- Author
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Barnabas Gellen, Florence Beauvais, Guillaume Baudry, Delphine Mika, Florian Zores, Théo Pezel, Damien Legallois, Chloé Motet, Charles Taieb, Lamia Tartière, Emmanuelle Berthelot, Julien Guihaire, Thibaud Damy, Frédéric Mouquet, Marie-Claude Aumont, Benoit Lequeux, Muriel Salvat, Jean-Christophe Eicher, and Michel Galinier
- Subjects
Male ,medicine.medical_specialty ,Lower limb edema ,Referral ,Hospitalized patients ,Clinical Investigations ,Cardiology ,030204 cardiovascular system & hematology ,comorbidities ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Health care ,medicine ,risk factors ,Humans ,030212 general & internal medicine ,healthcare pathway ,Aged ,Heart Failure ,business.industry ,Retrospective cohort study ,Mean age ,General Medicine ,medicine.disease ,Hospitalization ,Heart failure ,Acute Disease ,symptoms ,Cardiology and Cardiovascular Medicine ,business ,Delivery of Health Care ,Sudden onset - Abstract
Background Acute heart failure (AHF) is a common serious condition that contributes to about 5% of all emergency hospital admissions in Europe. Hypothesis To assess the type and chronology of the first AHF symptoms before hospitalization and to examine the French healthcare system pathways before, during and after hospitalization. Material and Methods A retrospective observational study including patients hospitalized for AHF Results 793 patients were included, 59.0% were men, 45.6% identified heart failure (HF) as the main cause of hospitalization; 36.0% were unaware of their HF. Mean age was 72.9 ± 14.5 years. The symptoms occurring the most before hospitalization were dyspnea (64.7%) and lower limb edema (27.7%). Prior to hospitalization, 47% had already experienced symptoms for 15 days; 32% of them for 2 months. Referral to hospital was made by the emergency medical assistance service (SAMU, 41.6%), a general practitioner (GP, 22.3%), a cardiologist (19.5%), or the patient (16.6%). The modality of referral depended more on symptom acuteness than on type of symptoms. A sudden onset of AHF symptoms led to making an emergency call or to spontaneously attending an emergency room (ER), whereas cardiologists were consulted when symptoms had already been present for over 15 days. Cardiologists referred more patients to cardiology departments and fewer patients to the ER than general practitioners or the SAMU. Conclusion This study described the French healthcare system pathways before, during and after hospitalization AHF. AHF clinic network should be developed to provide adequate care for all HF patients and create awareness regarding AHF symptoms.
- Published
- 2021