Purpose: Frequent hospitalizations represent a deterioration in the quality of life of patients in advanced heart failure stages. The objective of this study is to analyze the characteristics and pattern of hospital admissions of patients with heart failure and severe dysfunction of left ventricle followed in a unit of heart failure (UIC) in the 12 months prior to death.
Methods: Were analyzed retrospectively qualitative and quantitative variables of the patients followed in our unit from 2008 to 2013 as well as the pattern of hospitalization in the last 12 months prior to his death, comparing them with no dead patients
Results: We followed to 599 patients in our unit there were 47 dead (7.9%). The average age was 70 +/- 9.7 years, being 66% men and 34% women. They had an average of 30 +/-11% left ventricular ejection fraction of which 45.5% were diabetic, 18.2% EPOC, 31.8 % had renal failure, analytically with NTproBNP 283+/-547 and uric acid 6 +/- 4 mg/dl Sinus rhythm were 27.3% of patients and a heart rate 70 +/- 24lpm. Advanced functional grade (II-IV NYHA) was 70% of them, being treated with an angiotensin-converting-enzyme inhibitor 65 % of patients, 10 % with angiotensin II receptor blockers, 65 % with b blockers, 70 % with aldosterone antagonist, 95 % with oral diuretic, 45.5 % with antiplatelet therapy 72% of patients died from cardiac cause: 40.3% directly related to heart failure cause (multiorgan failure/cardiogenic shock) and 13.8% sudden death; and the rest of cause not heart. Patients who died in this period had a greater number of hospital readmissions (1.62 versus 0.2 p: 0,000) in relation to patients who were still alive and presented an average hospitable stay 2.24 times longer (28.55 days versus 12.77 days, p: 0.039)
Conclusions: Patients with heart failure in advanced stages have a greater number of readmissions and hospital stays which represents an important consumption of healthcare resources, specially their last year of life. It is important to implement and promote palliative measures for the final phases of life in these patients.