Journal of Clinical Medicine · 2023 · 14 citations · 10 references
MedicineCardiologyInternal MedicineCardiothoracic SurgeryCardiovascular NursingClinical CardiologyCardiovascular DiseaseHeart FailureCardiorenal SyndromeHeart Failure ReadmissionsHospital Readmissions ReductionMortality RatesMultidisciplinary Care PathwaysMultidisciplinary Heart Failure CarePrognostic ModelsPropensity Score Adjustment
Background: Individuals suffering from heart failure (HF) and cardiorenal syndrome (CRS) represent a special group of patients considering their age, multiple health issues, and treatment challenges. These factors make them more susceptible to frequent hospital stays and a higher mortality rate. UMIPIC is a multidisciplinary care model program for patients with heart failure follow up provided by internists and nurses who are experts in this entity. Our study delved into the effectiveness of this specialized care program (UMIPIC) in mitigating these risks for HF and CRS patients. Methods: We analyzed the medical records of 3255 patients diagnosed with HF and CRS types 2 and 4, sourced from the RICA registry. These patients were divided into two distinct groups: those enrolled in the UMIPIC program (1205 patients) and those under standard care (2050 patients). Using propensity score matching, we ensured that both groups were comparable. The study focused on tracking hospital admissions and mortality rates for one year after an HF-related hospital stay. Results: Patients in the UMIPIC group experienced fewer hospital readmissions due to HF compared to their counterparts (20% vs. 32%; Hazard Ratio [HR] = 0.48; 95% Confidence Interval [95% CI]: 0.40–0.57; p < 0.001). They also showed a lower mortality rate (24% vs. 36%; HR = 0.64; 95% CI: 0.54–0.75; p < 0.001). Furthermore, the UMIPIC group had fewer total hospital admissions (36% vs. 47%; HR = 0.58; 95% CI: 0.51–0.66; p < 0.001). Conclusions: The UMIPIC program, centered on holistic and ongoing care, effectively reduces both hospital admissions and mortality rates for HF and CRS patients after a one-year follow-up period.
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Gregg C. Fonarow, Maria Rosa Costanzo, Vandana Mathur et al. · Journal of Cardiac Failure · 2007 · 763 citations