Follow-Up Within 7 Days of Heart Failure Discharge Beneficial
One-year mortality and admission lower for patients with follow-up care within 7 days of discharge
(HealthDay News) -- For patients with heart failure, follow-up care within 7 days of discharge from the emergency department is associated with lower rates of long-term mortality and subsequent admissions, according to a study published in CMAJ, the journal of the Canadian Medical Association.
Clare L. Atzema, MD, from the University of Toronto, and colleagues conducted a retrospective cohort study among adult patients discharged from 1 of 163 emergency departments with a primary diagnosis of heart failure.
The researchers found that 47.1 and 83.6% of 34,519 patients obtained follow-up care within 7 and 30 days, respectively. The rate of mortality over 1 year was lower for patients with follow-up care within 7 days vs those with follow-up within 8 to 30 days (hazard ratio, 0.92); in addition, the rate of hospital admission over 90 days and 1 year was reduced (hazard ratios, 0.87 and 0.92, respectively) for those with follow-up care within 7 days. There was a trend toward a lower mortality rate over 90 days. Compared with patients without 30-day follow-up, follow-up care within 30 days was correlated with a reduction in 1-year mortality (hazard ratio, 0.89) but not hospital admission.
"Obtaining early follow-up for all of these patients will require a transition in systematic care between emergency and longitudinal care, via collaboration between administrators, researchers, clinicians, and information technology specialists," the authors write.
Atzema CL, Austin PC, Yu B, et al. Effect of early physician follow-up on mortality and subsequent hospital admissions after emergency care for heart failure: a retrospective cohort study. CMAJ December 17, 2018;190(50):E1468-E1477. DOI:10.1503/cmaj.180786