Characterization of the precipitants of hospitalization for heart failure decompensation

Susan Pressler, Gertrude A. Huster, Susan L. Baker, Lesley Braun Milgrom, Anne Kirchgassner, Judy Birt, Milton L. Pressler

Research output: Contribution to journalArticle

169 Citations (Scopus)

Abstract

BACKGROUND: The model for management of patients with heart failure may be a key determinant of morbidity and quality of life. Development of a better management strategy for these patients requires determination of the reasons for decompensation that leads to hospitalization. OBJECTIVES: To ascertain and rank the principal reasons for hospitalization of patients who have heart failure. METHODS: Retrospective audit of all 1992 admissions (N=1031; 691 patients) coded for heart failure at a Veterans Affairs medical center and a tertiary care university medical center. RESULTS: The diagnosis of heart failure was verified by preset criteria in 72% of the patients. Of the 496 patients with documented heart failure, worsening heart failure was a main reason for admission in 390 (79%). Despite different socioeconomic backgrounds, excessive sodium retention was the leading factor (55%) associated with decompensation in patients at both institutions. Other factors precipitated admission much less often. CONCLUSIONS: Many hospitalizations for heart failure might be avoided by case management directed at lessening sodium overload. Increased use of medications known to be effective in persons with heart failure (angiotensin-converting enzyme inhibitors, digoxin, and adequate diuretic therapy) might reduce the likelihood of decompensation. Implementation of behavioral interventions to assist patients with self-monitoring signs of sodium retention and to improve compliance with medications and dietary sodium restrictions are strategies for further reducing the risk of decompensation.

Original languageEnglish (US)
Pages (from-to)168-174
Number of pages7
JournalAmerican Journal of Critical Care
Volume7
Issue number3
StatePublished - May 1998

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Hospitalization
Heart Failure
Sodium
Dietary Sodium
Medication Adherence
Digoxin
Case Management
Veterans
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Tertiary Care Centers
Quality of Life
Morbidity

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)

Cite this

Pressler, S., Huster, G. A., Baker, S. L., Milgrom, L. B., Kirchgassner, A., Birt, J., & Pressler, M. L. (1998). Characterization of the precipitants of hospitalization for heart failure decompensation. American Journal of Critical Care, 7(3), 168-174.

Characterization of the precipitants of hospitalization for heart failure decompensation. / Pressler, Susan; Huster, Gertrude A.; Baker, Susan L.; Milgrom, Lesley Braun; Kirchgassner, Anne; Birt, Judy; Pressler, Milton L.

In: American Journal of Critical Care, Vol. 7, No. 3, 05.1998, p. 168-174.

Research output: Contribution to journalArticle

Pressler, S, Huster, GA, Baker, SL, Milgrom, LB, Kirchgassner, A, Birt, J & Pressler, ML 1998, 'Characterization of the precipitants of hospitalization for heart failure decompensation', American Journal of Critical Care, vol. 7, no. 3, pp. 168-174.
Pressler S, Huster GA, Baker SL, Milgrom LB, Kirchgassner A, Birt J et al. Characterization of the precipitants of hospitalization for heart failure decompensation. American Journal of Critical Care. 1998 May;7(3):168-174.
Pressler, Susan ; Huster, Gertrude A. ; Baker, Susan L. ; Milgrom, Lesley Braun ; Kirchgassner, Anne ; Birt, Judy ; Pressler, Milton L. / Characterization of the precipitants of hospitalization for heart failure decompensation. In: American Journal of Critical Care. 1998 ; Vol. 7, No. 3. pp. 168-174.
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