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Congestive heart failure (CHF) is associated with prolonged and recurrent hospitalizations, the prognosis remains poor. Analysis of epidemiology, healthcare consumption and prognosis at one year of a cohort of hospitalized patients for congestive heart failure in Saint Joseph Hospital (SHJ), using the SNDS data base (National data base). From September 2016 to September 2018 all patients hospitalized for CHF in SJH were included. CHF was assessed by ESC criteria. Clinical and biological data were collected from the electronic health record. The follow up was one year. At this date, using SNDS data base, were collected mortality, re-hospitalization for CHF, re-hospitalization for other reason, drug prescription, healthcare consumption. Six hundred and fifteen patients were included, 287 female (46.7%), the mean age 78.43 years (±11.10). Mean Ejection Fraction (EF) was 45.3% (±15.0), 199patients (32.36%) with preserved EF, ischemic disease for 370 patients (60.2%), 275 (44.7%) were in sinus rhythm. At discharge median BNP was 350.0 ng/ml [174;770], mean Hemoglobin 12.4 g/dl (±1.82), 323 patients (52.5%) with anemia (Hb < 12 g/dl). At one year the rates of drug consumption were for Conversion enzymeinhibitor or Angiotensine receptor antagonist 65.0%, loop diuretics 93.0%, spironolactone/eplerenone 27.7%, beta blocker 70.2%, oral direct anticoagulant34.9%, AVK 29.1%, antiplatelet agent 42.3%. At one year 563 patients (91.5%) had a general practitioner (GP) consultation (CS), the median number of GP CSwas 11 [7.0; 16.0], the median delay for the first GP CS was 13.0 days [6.0; 39.5], 400 (65%) had a cardiologist (C) CS, the median delay for the first C CSwas 55 days [28.0; 116.0]. Re-hospitalization rate for CHF was 36.75%, median delay 55 days [20.0; 156.2], 431 (70.0%) were re hospitalized for other reason atone year, median delay 61.0 days [20.0; 156.0], median number 2.0 [1.0; 4.0]. The mortality rate was 18.21%. The median delay of death occurrence was 137.0days [63.7; 240.0]. The composite index death or re-hospitalization concerned 484 (78.7%) patients of our cohort (Fig. 1). Our study confirmed that the CHF population had a poor prognosis despite health care policy and programs. Qualitative and quantitative improvement of the care pathway are needed. [ABSTRACT FROM AUTHOR]

The rate of one-year mortality in congestive heart failure (CHF) is high. Several reversible factors could be identified in analysis of observational studies using follow up data. Analysis of factors associated with mortality at one year in a cohort of hospitalized patients for congestive heart failure in Saint Joseph Hospital (SHJ), using the SNDS data base (National data base). From September 2016 to September 2018 all patients hospitalized for CHF in SJH were included. CHF was assessed by ESC criteria. Two groups were built, dead (D) or alive (A). Clinical and biological data, collected from the electronic health record, and follow up data, using SNDS data base, were compared between the two groups. Six hundred and fifteen patients were included. Univariate analysis showed significant differences between the two groups: In the group D, population was older (82.5 ± 9.0 vs 77.5 ± 11.3 years, P < 0.0001), the mean Ejection Fraction was higher (47.7 ± 14.4 vs 44.7 ± 15.1%, P = 0.04), median BNP level at discharge higher (586.0 vs 318,0 P < 0.0001), mean creatinin level higher (147 ± 56 vs 130 ± 63 μmoles/l, P = 0.0006), mean Sodium level lower (135.1 ± 4.2 vs 136.4 ± 4.0 mmoles/l, P = 0.0024), mean hemoglobin lower (11.6 ± 1.6 vs 12.5 ± 1.8 g/dl, P < 0.0001). The rates of conversion enzyme inhibitor or angiotensin receptor blocker (EIC/ARB) consumption was lower (52.6 vs 67.8%, P = 0.0024), beta blocker lower (59.8 vs 72.5%, P = 0.0076), oral direct anticoagulant (ODA) lower (22.3 vs 37.7%, P = 0.0019). In multivariate analysis using Cox model, inclusion in PRADO program (support program for returning home) showed no difference (HR = 0.88 IC95% [0.60; 1.30] P = 0.53). The significate data were, at discharge, Creatinin >100 μmoles/l (HR = 1.76 [1.06; 2.90] P = 0.02), Sodium level > 135 mmoles/l (HR = 0.68 [0.46; 0.99], P = 0.04), Hemoglobin level > 12 g/dl (HR = 0.62 [0.41; 0.93], P = 0.01), and consumption of ODA (HR = 0.57 [0.35; 0.91], P = 0.018), and EIC/ARB (HR = 0.49 [0.31; 0.79], P = 0.003) (Figure 1). Our study confirmed that the CHF population had a poor prognosis despite health care policy and programs. The main factors of poor prognosis are biological data at discharge, reflecting the severity of CHF. [ABSTRACT FROM AUTHOR]

Congestive heart failure (CHF) is associated with prolonged and recurrent hospitalizations for CHF and for other reasons, since comorbidities are frequently associated. Analysis of factors associated with re-hospitalization for any reason (CHF and others reasons) at one year in a cohort of hospitalized patients for congestive heart failure in Saint Joseph Hospital (SHJ), using the SNDS data base (National database). From September 2016 to September 2018 all patients hospitalized for CHF in SJH were included. CHF was assessed by ESC criteria. Two groups were built: Re-hospitalization for any reason (H), no–rehospitalization (NH). Clinical and biological data, collected from the electronic health record, and follow up data, using SNDS data base, were compared between the two groups. Six hundred and fifteen patients were included. Univariate analysis showed significant differences between the two groups: In the group H (n = 431, 70.08%), the number of male was higher (57.5 vs 43.4%, OR 1.76 [95% CI] [1.24; 2.50] P = 0.001). The number of people older than 81 years was lower (45.0% vs 54.3%, OR 0.69 [0.49; 0.97] P = 0.03). The mean LV Ejection fraction (EF) was higher (46.0 ± 14.8% vs 43.5 ± 15.5%, P = 0.05). Cancer was more frequent (19.2% vs 10.3%, OR 2.07 [1.22; 3.53], P = 0.006). At discharge, mean Hemoglobin was lower (12.2 ± 1.8 vs 12.6 ± 1.8, P = 0.009). In the H group were more prescribed loop diuretics (95.1% vs 88.0%, OR 2.65 [1.42; 4.95], P = 0.001). The median number of consultation with general practitioner is higher (12 [8; 17] vs 9 [6; 14], P < 0.0001). Mortality rate is higher (20.8% vs 11.9%, OR 1.94 [1.18; 3.21], P = 0.008). Multivariate analysis showed that male gender (HR 1.47 [1.19; 1.82], P = 0.0003), age lower than 81 years (HR 0.72 [0.59; 0.88], P = 0.001), EF > 50% (HR 1.63[1.23; 2.16], P = 0.0007), cancer disease (HR = 1.46, [1.14; 1.86], P = 0.002) loop diuretics prescription (HR 1.78 [1.14; 2.77], P = 0.01), were significantly related with rehospitalization for any reasons. Our study confirmed that the CHF population had a very frequent re-hospitalization for any reason, reflecting frailty and comorbidities. The main factors related are male gender, age lower than 81 years, cancer, preserved EF. [ABSTRACT FROM AUTHOR]

Congestive heart failure (CHF) is associated with prolonged and recurrent hospitalizations, the prognosis remains poor. Analysis of follow up data could identify related factors. Analysis of factors associated with re-hospitalization for CHF, at one year in a cohort of hospitalized patients for congestive heart failure in Saint Joseph Hospital (SHJ), using the SNDS database (National data base). From September 2016 to September 2018 all patients hospitalized for CHF in SJH were included. CHF was assessed by ESC criteria. Two groups were built: Re-hospitalization for CHF (R), no-rehospitalization for CHF (N). Clinical and biological data, collected from the electronic health record, and follow up data, using SNDS database, were compared between the two groups. Six hundred and fifteen patients were included. Univariate analysis showed significant differences between the two groups: In the group R (n = 226, 36.75%), the number of people older than 81 years was lower (42.4% vs 50.9%, OR 0.71 [IC 95%] [0.51; 0.99], P = 0.04). The mean LV Ejection fraction was lower (43.7 ± 15.1 vs 46.2 ± 14.9%, P = 0.03). At discharge, median BNP was higher (387 [199;863] vs 320 [167; 703] ng/ml, P = 0.002), mean creatinin higher (139 ± 61 vs 130 ± 63 μmoles/l, P = 0.007). In the R group were more prescribed converting Enzyme inhibitor or Angiotensin receptor blocker (71.2 vs 61.2%, OR 1.55 [1.09; 2.21], P = 0.001), loop diuretics (98.2 vs 89.9%, OR 6.18 [2.18; 17.54], P = 0.0001), spironolactone/eplerenone (34.9 vs 23.3%, OR 1.76 [1.23; 2.52], P = 0.002), antiplatelet agents (48.6 vs 36.5%, OR 1.65 [1.18; 2.30], P = 0.001). The median number of consultation with general practitioner is higher (12 [7; 17] vs 11 [7; 15], P = 0.03). Mortality rate is higher but not significate (22.1 vs 15.9%, OR 1.50 [0.99; 2.27], P = 0.06). Multivariate analysis showed that creatinin < 100 μmoles/l at discharge (HR 1.39 [1.02; 1.89], P = 0.03), loop diuretics prescription (HR 4.02 [1.046; 11.03], P = 0.006), and antiplatelet agents (HR 1.50 [1.11; 2.01], P = 0.007) were significantly related with rehospitalization for CHF. Our study confirmed that the CHF population had a frequent re-hospitalization for CHF despite health care policy and programs. The main factors related are biological data at discharge, and healthcare consumption during follow up. [ABSTRACT FROM AUTHOR]

Background: Intra-hospital transport of patients is often a source of pain for them. To decrease it, improvements were made in various areas related to transportation between 2014 and 2017 and the results were evaluated on these two dates. Methods: Using questionnaires, we interviewed hospitalized patients before and after their transportation. We assessed their pre-existing and transport-induced pain, pain caused by waiting time, installation and reinstallation on the different devices and the irregularities of the floor. Results: Fifty-eight (35 H + 23 F) and 162 (91 H + 71 F) patients responded to the surveys, with an average age of 59.6 ± 16.6 years and 66.4 ± 14.6 years in 2014 and 2017, respectively. The modes of transportation were bed, stretcher and wheelchair, used 22, 12 and 19 times (36, 20, 31%) in 2014, and 31, 54 and 44 times (19, 33 and 27%) in 2017. In 2017, fewer patients were painful during transport (13.6% in 2017 compared to 25.8% in 2014) and the intensity of the pain was lower (0.98/10 compared to 2.17/10). The mobilization, the waiting and the quality of the soils caused less pain in 2017.Conclusion: Numerous logistical actions, the training of staff, particularly nurses and stretcher bearers, and the improvement of the quality of the grounds, have made it possible to reduce pain and to improve patient comfort during transport. [ABSTRACT FROM AUTHOR]