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Observational Study
. 2021 Aug;44(8):1144-1150.
doi: 10.1002/clc.23666. Epub 2021 Jun 26.

First symptoms and health care pathways in hospitalized patients with acute heart failure: ICPS2 survey. A report from the Heart Failure Working Group (GICC) of the French Society of Cardiology

Florence Beauvais  1 , Lamia Tartière  2 , Théo Pezel  1 , Chloé Motet  3 , Marie-Claude Aumont  4 , Guillaume Baudry  5 , Jean-Christophe Eicher  6 , Michel Galinier  7 , Barnabas Gellen  8 , Julien Guihaire  9 , Damien Legallois  10 , Benoit Lequeux  11 , Delphine Mika  12 , Frederic Mouquet  13 , Muriel Salvat  14 , Charles Taieb  15 , Florian Zorès  16 , Emmanuelle Berthelot  17 , Thibaud Damy  18
Affiliations
Observational Study

First symptoms and health care pathways in hospitalized patients with acute heart failure: ICPS2 survey. A report from the Heart Failure Working Group (GICC) of the French Society of Cardiology

Florence Beauvais et al. Clin Cardiol. 2021 Aug.

Abstract

Background: Acute heart failure (AHF) is a common serious condition that contributes to about 5% of all emergency hospital admissions in Europe.

Hypothesis: To assess the type and chronology of the first AHF symptoms before hospitalization and to examine the French healthcare system pathways before, during and after hospitalization.

Material and methods: A retrospective observational study including patients hospitalized for AHF RESULTS: 793 patients were included, 59.0% were men, 45.6% identified heart failure (HF) as the main cause of hospitalization; 36.0% were unaware of their HF. Mean age was 72.9 ± 14.5 years. The symptoms occurring the most before hospitalization were dyspnea (64.7%) and lower limb edema (27.7%). Prior to hospitalization, 47% had already experienced symptoms for 15 days; 32% of them for 2 months. Referral to hospital was made by the emergency medical assistance service (SAMU, 41.6%), a general practitioner (GP, 22.3%), a cardiologist (19.5%), or the patient (16.6%). The modality of referral depended more on symptom acuteness than on type of symptoms. A sudden onset of AHF symptoms led to making an emergency call or to spontaneously attending an emergency room (ER), whereas cardiologists were consulted when symptoms had already been present for over 15 days. Cardiologists referred more patients to cardiology departments and fewer patients to the ER than general practitioners or the SAMU.

Conclusion: This study described the French healthcare system pathways before, during and after hospitalization AHF. AHF clinic network should be developed to provide adequate care for all HF patients and create awareness regarding AHF symptoms.

Keywords: comorbidities; healthcare pathway; heart failure; hospitalization; risk factors; symptoms.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Patient care pathway, from the symptom‐appearing phase to the post‐hospital phase
See this image and copyright information in PMC

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