Compliance of the management of hospitalized patients with heart failure with the quality criteria for health care: data from the St. Petersburg registry

Q3 Medicine

Russian Journal of Cardiology Pub Date : 2023-12-28 DOI:10.15829/1560-4071-2023-5621

G. V. Endubaeva, A. E. Solovyova, A. E. Medvedev, M. M. Kurbanova, E. I. Kogan, T. V. Gorbacheva, A. V. Yazenok, N. Zvartau, S. Villevalde

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引用次数: 0

Abstract

Aim. To assess the compliance of the management of patients with heart failure (HF) with quality criteria (QC) for health care, including discharge instructions for patients.Material and methods. Hospitalizations of patients aged over 18 years with HF (ICD 10 code — I50.x) during the period from January 1, 2019 to October 1, 2020 were randomly selected from the "Chronic Heart Failure" registry of St. Petersburg. Discharge and post-mortem summaries were assessed for compliance with the quality criteria listed in the 2020 Russian Chronic Heart Failure guidelines.Results. The study included 553 patients (women, 71,1%, mean age, 82,0±9 years, comorbidities: hypertension — 99,1%, coronary artery disease — 97,6%, chronic kidney disease — 53,2%, diabetes — 32,6%). Electrocardiography (QC № 1) was performed in 94,2% of patients, chest radiography (QC № 2) 91,7%, echocardiography (QC № 3) — 81,0%, but the results were not always informative. The exact ejection fraction (EF) value was reported in 55,4% of patients. Laboratory examination corresponded to QC № 4-6 in 20,3% of cases and was performed in 53,3-94,9%. Natriuretic peptides (NPs) were not determined (QC № 7-0%).The completeness of intravenous therapy (QC № 8) was not assessed due to insufficient physical examination data.Oral therapy (QC № 9) was prescribed frequently as follows: renin-angiotensinaldosterone system inhibitors (RAASo) — 93,3%, beta blockers (BBs) — 85,4%, mineralocorticoid receptor antagonists (MRAs) — 78,7%. However, triple RAAS+BB+MRA therapy was carried out in 54,1% of HF cases with EF <50% and no contraindications.Diet was recommended in 87,1% of summaries, water-salt regimen — 53,3%, drug titration — 8,2%. The date of visit to outpatient cardiologist was indicated in 10,0%.Conclusion. With the exception of NP assessment, the scope of paraclinical studies corresponded to the QC in the majority of patients. Optimal therapy was prescribed to 54,1% of patients with EF <50%. An early outpatient visit after discharge was indicated in 10,0% of summaries.

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心力衰竭住院患者的管理是否符合医疗质量标准：圣彼得堡登记处提供的数据

目的评估对心力衰竭（HF）患者的管理是否符合医疗质量标准（QC），包括对患者的出院指导。从圣彼得堡 "慢性心力衰竭 "登记处随机抽取了 2019 年 1 月 1 日至 2020 年 10 月 1 日期间住院的 18 岁以上心力衰竭患者（ICD 10 代码 - I50.x）。根据2020年俄罗斯慢性心力衰竭指南中列出的质量标准，对出院和尸检摘要进行了评估。研究共纳入 553 名患者（女性占 71.1%，平均年龄（82.0±9）岁，合并症：高血压 99.1%，冠心病 97.6%，慢性肾病 53.2%，糖尿病 32.6%）。94.2%的患者进行了心电图检查（QC № 1），91.7%的患者进行了胸片检查（QC № 2），81.0%的患者进行了超声心动图检查（QC № 3），但检查结果不一定具有参考价值。55.4%的患者报告了确切的射血分数（EF）值。在 20.3% 的病例中，实验室检查符合 QC № 4-6 标准，在 53.3-94.9% 的病例中进行了实验室检查。口服治疗（QC № 9）的常用处方如下：肾素-血管紧张素-睾酮系统抑制剂（RAASo）--93.3%，β受体阻滞剂（BBs）--85.4%，矿物质皮质激素受体拮抗剂（MRAs）--78.7%。然而，在 EF <50% 且无禁忌症的心房颤动病例中，54.1% 的患者接受了 RAAS+BB+MRA 三联疗法。87.1% 的病例总结建议饮食治疗，53.3% 的病例建议水盐疗法，8.2% 的病例建议药物滴定治疗。10.0%的总结中注明了心脏科门诊医生的就诊日期。除 NP 评估外，大多数患者的临床旁研究范围与质量控制相符。54.1%的 EF 值小于 50% 的患者接受了最佳治疗。10.0%的总结指出出院后应尽早到门诊就诊。

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来源期刊

Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.20

自引率

0.00%

发文量

185

审稿时长

1 months

期刊介绍： Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.