Unité de suivi des patients insuffisants cardiaques, Clinique du Diaconat, Mulhouse, France, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Service de physiologie et d’explorations fonctionnelles, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Équipe de recherche EA 3072 « Mitochondrie, stress oxydant et protection musculaire », Faculté de médecine de Strasbourg, Université de Strasbourg, Strasbourg, France
Service de médecine interne, diabète et maladies métaboliques, Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Département de santé publique/DIM et biostatistiques, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Unité fonctionnelle dédiée à l’insuffisance cardiaque, Pôle médical et chirurgical des maladies cardiovasculaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Objective: The objective of this study is to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education, led to better management of these patients. Patients and Method: This was a monocentric, retrospective study on a cohort of patients with a proven CHF, followed in the Mulhouse region (France), between January 2016 and December 2017, by the Unit for Monitoring Heart Failure Patients (USICAR). These patients benefited from a regular protocolized follow-up and a therapeutic education program for a period of 2 years. The main criterion of this study was: the number of days of hospitalization for HF per year and per patient. The secondary endpoints were: the number of days of hospitalization for cardiac causes other than HF and the number of hospital stays for HF per patient. These criteria were collected over the one-year period before inclusion, at one-year-follow-up, and at two-years-follow-up. Results: 159 patients with a mean age of 72.9 years were included in this study. They all had a CHF, mainly stage I-II NYHA (88.7%), of predominantly ischemic origin (50.9%), with altered left ventricular ejection fraction in 69.2% of cases. The primary endpoint averaged 8.33 days (6.84-10.13) in the year prior to inclusion, 2.6 days (1.51-4.47) in the first year of follow-up, and 2.82 days (1.30-6.11) (p <0.01 for both comparisons). The mean number of days of hospitalization for other cardiac causes other than HF to patient numbers was: 1.73 days (1.16-2.6), 1.81 days (1.04-3.16), and 1.32 days (0.57-3.08) (p = ns). The percentage of hospitalization for HF for each patient was: 69.5% (60.2-77.4) before inclusion, 16.2% (10-25.2) during the first year of follow-up and 19.3% (11-31.8) during the second (p < 0.001 for both comparisons). Conclusion: This study demonstrates the value of a protocolized follow-up associated with a therapeutic education program to improve the management of ambulatory CHF patients, particularly for moderate CHF.