Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study

Introduction and aim: Palliative care in patients with advanced heart failure is strongly recommended by Clinical Practice Guidelines. We aimed to calculate the prevalence of advanced heart failure in admitted patients, to describe their management, and to analyse the factors that influence their re...

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Autores: Fernández-Martinez, Javier, Romero-Correa, Miriam, Salamanca Bautista, María del Prado, Aramburu-Bodas, Óscar, Formiga, Francesc, Vázquez-Rodríguez, Patricia, Conde-Martel, Alicia, García García, José Ángel, Arias-Jiménez, José Luis, EPICTER Investigators group
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2021
País:España
Recursos:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/180438
Acesso em linha:https://hdl.handle.net/11441/180438
https://doi.org/10.1016/j.ijcard.2020.11.002
Access Level:acceso abierto
Palavra-chave:Advanced heart failure
Palliative Care
Elderly
Comorbidities
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spelling Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter studyFernández-Martinez, JavierRomero-Correa, MiriamSalamanca Bautista, María del PradoAramburu-Bodas, ÓscarFormiga, FrancescVázquez-Rodríguez, PatriciaConde-Martel, AliciaGarcía García, José ÁngelArias-Jiménez, José LuisEPICTER Investigators groupAdvanced heart failurePalliative CareElderlyComorbiditiesIntroduction and aim: Palliative care in patients with advanced heart failure is strongly recommended by Clinical Practice Guidelines. We aimed to calculate the prevalence of advanced heart failure in admitted patients, to describe their management, and to analyse the factors that influence their referral to specialised palliative care. Patients and methods: Cross-sectional, multicentre study that consecutively included patients admitted for heart failure in 74 Spanish hospitals. If they met criteria for advanced heart failure, their treatment, complications and procedures were recorded. Results: A total of 3153 patients were included. Of them, 739 (23%) met criteria for advanced heart failure. They were more likely to be women, older and to have a history of anaemia, chronic kidney disease and cognitive impairment. For their management, furosemide infusions (30%) and vasodilators (21%) were used. Refractory symptoms were treated with opioids (47%) and benzodiazepines (44%). Palliative care was only provided in the last hours of life in 48% of them. A multidisciplinary approach, involving palliative care specialists was sought in 15% of these patients. Treatment with furosemide infusions, an advanced New York Heart Association functional class, to meet advanced HF criteria and the presence of cancer were associated with the referral to specialised palliative care. Conclusions: Almost one in four patients admitted with HF met criteria of advanced disease. They were older and had more comorbidities. Specialist palliative care services were involved in only a minority of patients, mainly those who were highly symptomatic or had cancer.ElsevierMedicina2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/180438https://doi.org/10.1016/j.ijcard.2020.11.002reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésInternational Journal of Cardiology, 321, 125-131.https://www.internationaljournalofcardiology.com/article/S0167-5273(20)34076-6/abstractinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1804382026-06-17T12:51:07Z
dc.title.none.fl_str_mv Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
title Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
spellingShingle Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
Fernández-Martinez, Javier
Advanced heart failure
Palliative Care
Elderly
Comorbidities
title_short Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
title_full Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
title_fullStr Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
title_full_unstemmed Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
title_sort Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the epicter study
dc.creator.none.fl_str_mv Fernández-Martinez, Javier
Romero-Correa, Miriam
Salamanca Bautista, María del Prado
Aramburu-Bodas, Óscar
Formiga, Francesc
Vázquez-Rodríguez, Patricia
Conde-Martel, Alicia
García García, José Ángel
Arias-Jiménez, José Luis
EPICTER Investigators group
author Fernández-Martinez, Javier
author_facet Fernández-Martinez, Javier
Romero-Correa, Miriam
Salamanca Bautista, María del Prado
Aramburu-Bodas, Óscar
Formiga, Francesc
Vázquez-Rodríguez, Patricia
Conde-Martel, Alicia
García García, José Ángel
Arias-Jiménez, José Luis
EPICTER Investigators group
author_role author
author2 Romero-Correa, Miriam
Salamanca Bautista, María del Prado
Aramburu-Bodas, Óscar
Formiga, Francesc
Vázquez-Rodríguez, Patricia
Conde-Martel, Alicia
García García, José Ángel
Arias-Jiménez, José Luis
EPICTER Investigators group
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Medicina
dc.subject.none.fl_str_mv Advanced heart failure
Palliative Care
Elderly
Comorbidities
topic Advanced heart failure
Palliative Care
Elderly
Comorbidities
description Introduction and aim: Palliative care in patients with advanced heart failure is strongly recommended by Clinical Practice Guidelines. We aimed to calculate the prevalence of advanced heart failure in admitted patients, to describe their management, and to analyse the factors that influence their referral to specialised palliative care. Patients and methods: Cross-sectional, multicentre study that consecutively included patients admitted for heart failure in 74 Spanish hospitals. If they met criteria for advanced heart failure, their treatment, complications and procedures were recorded. Results: A total of 3153 patients were included. Of them, 739 (23%) met criteria for advanced heart failure. They were more likely to be women, older and to have a history of anaemia, chronic kidney disease and cognitive impairment. For their management, furosemide infusions (30%) and vasodilators (21%) were used. Refractory symptoms were treated with opioids (47%) and benzodiazepines (44%). Palliative care was only provided in the last hours of life in 48% of them. A multidisciplinary approach, involving palliative care specialists was sought in 15% of these patients. Treatment with furosemide infusions, an advanced New York Heart Association functional class, to meet advanced HF criteria and the presence of cancer were associated with the referral to specialised palliative care. Conclusions: Almost one in four patients admitted with HF met criteria of advanced disease. They were older and had more comorbidities. Specialist palliative care services were involved in only a minority of patients, mainly those who were highly symptomatic or had cancer.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/180438
https://doi.org/10.1016/j.ijcard.2020.11.002
url https://hdl.handle.net/11441/180438
https://doi.org/10.1016/j.ijcard.2020.11.002
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Cardiology, 321, 125-131.
https://www.internationaljournalofcardiology.com/article/S0167-5273(20)34076-6/abstract
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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