Failed by Hearts -- and Hospitals

Patients with heart failure admitted to general hospitals are twice as likely to die as those admitted to cardiology wards

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A new UK study finds heart-failure patients are twice as likely to die if they're admitted to general hospitals as opposed to cardiology wards.

Heart failure accounted for more than a quarter of a million hospital deaths and discharges in England and Wales in 2006 and 2007.

Researchers looked at surveys from the first 10 patients admitted to some 86 hospitals each month between April 2008 and March 2009. Each patient -- just more than 6,000 in all with an average age of 78 -- had a primary diagnosis of heart failure. The study found women fared worse than men where investigations and treatments were concerned, but overall death rates were similar between genders.

Appropriate investigations were not always carried out, according to the study. Those admitted to cardiology wards, rather than general-care wards, were more likely to receive more thorough investigations. Upon admission, only 43 percent of patients were reported to have swollen ankles and feet, and only 30 percent were reported to be breathless. These are two diagnostic features of heart failure. Most patients were given a heart-trace monitor test (echocardiogram), but only 65 percent admitted to general wards were given this test.

Perhaps most jarringly, those admitted to general wards had twice the mortality rate than heart-failure patients admitted to cardiology wards.

For patients whose discharge drug treatment was recorded, most were given the appropriate medicines, though only half (mostly men and younger patients) were prescribed beta blockers. These medications decrease heart rate, causing the heart to beat more slowly and with less force.

The study authors conclude "a disease with such a malign prognosis as heart failure" should be given the same care and consideration cancer patients receive. They report current hospital provisions in the UK are "suboptimal and the outcome of patients poor."

The rate of death from heart failure after 1 year is about 10 percent in the United States.

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Review Date: 
January 18, 2011
Last Updated:
January 19, 2011