Abstract P215: Primary Cardiology Service Versus Cardiology Consultation: Differences in Heart Failure Patients' Medication Regimens on Discharge
Abstract only Introduction: Patients with congestive heart failure (CHF) exacerbation are increasingly admitted to a hospitalist service with a cardiology consultation (CC) versus a primary cardiology service (PCS). Our study investigates differences in discharge medication regimens, heart rate (HR)...
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| Published in: | Circulation Cardiovascular quality and outcomes Vol. 4; no. suppl_2 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
01-11-2011
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| Online Access: | Get full text |
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| Summary: | Abstract only
Introduction:
Patients with congestive heart failure (CHF) exacerbation are increasingly admitted to a hospitalist service with a cardiology consultation (CC) versus a primary cardiology service (PCS). Our study investigates differences in discharge medication regimens, heart rate (HR) and blood pressure (BP) between these two groups. We hypothesize that PCS patients are more likely to be discharged with appropriate CHF medication regimens and have lower HR and BP.
Methods:
All patients admitted to Cooper University Hospital with CHF exacerbation from 9/1/03 to 8/30/05 were included. A total of 415 consecutive admissions were included. Demographic, past medical history, admission and discharge medication regimens, and discharge vital signs were collected. Chi-square analysis and student's t-test were used for statistical analysis.
Results:
Forty percent of our study population was female. The mean age was 65.9 years and forty five percent were White. Two thirds of patients were managed on a PCS. Both groups had 40% female patients and an average age of 65 years, however there were significantly more White patients on the PCS. Rates of atrial fibrillation, hypertension and diabetes mellitus were equivalent between the two groups. However, renal disease was more frequent in CC group. The mean length of stay was equivalent between both groups as was systolic function. PCS patients were more likely to be admitted with ACE inhibitors, diuretics and aldosterone inhibitors than CC patients. On discharge, PCS patients were more likely to be discharged with digoxin (p<0.01), diuretics (p<0.001), beta-blockers (p<0.05) and aldosterone antagonists (p<0.01). On discharge, PCS patients had lower HR (p<0.01) and BP (p<0.05) than CC patients.
Conclusions:
Our study shows that discharge medication regimens for CHF vary significantly between patients taken care under a PCS as compared to a CC service. We hypothesize by being on the PCS, patients are more frequently reassessed and thus have greater opportunities for inpatient medication adjustment. These medication regimen differences manifest in clinical vital sign changes upon discharge between the two groups. Further study is warranted to see if these differences from 5-7 years ago continue to the present day. |
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| ISSN: | 1941-7713 1941-7705 |
| DOI: | 10.1161/circoutcomes.4.suppl_2.AP215 |