Table 1.
HF admissions
| All HF Admissions | HFrEF | HFpEF | VHF | |||||
| 2012/13 | 2015/16 | 2012/13 | 2015/16 | 2012/13 | 2015/16 | 2012/13 | 2015/16 | |
| Pre-IHFS | Post-IHFS | Pre-IHFS | Post-IHFS | Pre-IHFS | Post-IHFS | Pre-IHFS | Post-IHFS | |
| Coded diagnosis of HF | 420 | 576 | ||||||
| Readmissions<30 days | 35 | 36 | ||||||
| Confirmed HF admissions | 385 | 540 | ||||||
| Subtyped admissions | (350) | (505) | 135 | 210 | 147 | 181 | 68 | 114 |
| Alive at discharge | 338 | 468 | 117 | 189 | 135 | 162 | 56 | 96 |
| Cardiology ward | 31.4% (121) | 42.8% (231) (p<0.001) | 41.5% (56) | 54.3% (114) (p=0.020) | 27.8% (41) | 32.0% (58) (p=0.415) | 29.4% (20) | 50.9% (58) (p=0.005) |
| Cardiologist | 35.1% (135) | 43.7% (236) (p=0.009) | 48.1% (65) | 54.3% (114) (p=0.265) | 29.9% (44) | 34.3% (62) (p=0.405) | 32.4% (22) | 51.8% (59) (p=0.011) |
| HF specialist input | 81.6% (314) | 85.4% (461) (p=0.121) | 88.9% (120) | 92.4% (194) (p=0.268) | 75.5% (111) | 78.4% (142) (p=0.528) | 85.3% (58) | 91.2% (104) (p=0.216) |
| Echo | 70.1% (270) | 81.5% (440) (p<0.001) | 82.2% (111) | 87.6% (184) (p=0.165) | 72.1% (106) | 81.2% (147) (p=0.051) | 73.5% (50) | 92.1% (105) (p<0.001) |
| HFrEF meds ACEi/ARB | 62% | 100% | ||||||
| Beta-blockers | 50% | 100% | ||||||
| MRA | 50% | 99% | ||||||
| All three medications | 42% | 99% (p<0.001) | ||||||
| Mean length of stay (days) | 7.7 | 9.2 (p=0.010) | 9.0 | 10.2 | 6.8 | 8.5 | 8.4 | 11.7 |
| Mortality* | 20.0% (77) | 18.3% (99) (p=0.524) | 18.5% (25) | 17.1% (36) (p=0.744) | 16.3% (24) | 13.3% (24) (p=0.435) | 20.6% (14) | 21.1% (24) (p=0.941) |
| In-patient | 12.2% (47) | 13.3% (72) (p=0.614) | 13.3% (18) | 10.0% (21) (p=0.340) | 8.2% (12) | 10.5% (19) (p=0.472) | 17.6% (12) | 15.8% (18) (p=0.744) |
| <30 days post-d/c† | 8.9% (30) | 5.7% (27) (p=0.090) | 6.0% (7) | 7.9% (15) (p=0.520) | 8.9% (12) | 3.1% (5) (p=0.032) | 3.6% (2) | 6.3% (6) (p=0.476) |
| Readmission <30 days† | 21.6% (73) | 20.1% (94) (p=0.601) | 21.4% (25) | 20.6% (39) (p=0.878) | 21% (28) | 18.5% (30) (p=0.630) | 25% (14) | 21.9% (21) (p=0.659) |
| Related to HF | 10.7% (36) | 8.3% (39) (p=0.264) | 11.1% (13) | 10.6% (20) (p=0.885) | 10.4% (14) | 4.3% (7) (p=0.043) | 10.7% (6) | 10.4% (10) (p=0.954) |
| Unrelated to HF | 10.9% (37) | 11.8% (55) (p=0.723) | 10.3% (12) | 10.1% (19) (p=0.954) | 10.4% (14) | 14.2% (23) (p=0.320) | 14.3% (8) | 11.5% (11) (p=0.611) |
| Cardiology ward | ||||||||
| Confirmed HF admissions | 121 | 231 | 56 | 114 | 41 | 58 | 20 | 58 |
| Mean length of stay (days) | 8.4 | 12.7 | 8.6 | 12.6 | 7.5 | 9.7 | 11.1 | 15.9 |
| Mortality | 14.9% (18) | 15.2% (35) (p=0.945) | 14.3% (8) | 14.0% (16) (p=0.965) | 14.6% (6) | 8.6% (5) (p=0.348) | 20.0% (4) | 22.4% (13) (p=0.822) |
| In-patient | 12.4% (15) | 10.8% (25) (p=0.658) | 8.9% (5) | 9.6% (11) (p=0.880) | 14.6% (6) | 6.9% (4) (p=0.208) | 20.0% (4) | 15.5% (9) (p=0.643) |
| <30 days post-d/c | 2.8% (3) | 4.9% (10) (p=0.397) | 5.9% (3) | 4.9% (5) (p=0.787) | 0% | 1.9% (1) | 0% | 8.2% (4) |
| Readmission <30 days | 17.9% (19) | 16.5% (34) (p=0.752) | 17.6% (9) | 18.4% (19) (p=0.904) | 17.1% (6) | 11.1% (6) (p=0.416) | 25% (4) | 18.4% (9) (p=0.565) |
| Related to HF | 10.4% (11) | 6.8% (14) (p=0.270) | 9.8% (5) | 8.7% (9) (p=0.829) | 11.4% (4) | 1.9% (1) (p=0.055) | 6.3% (1) | 8.2% (4) (p=0.803) |
| Unrelated to HF | 7.5% (8) | 9.7% (20) (p=0.527) | 7.8% (4) | 9.7% (10) (p=0.705) | 5.7% (2) | 9.3% (5) (p=0.544) | 18.8% (3) | 10.2% (5) (p=0.366) |
| Non-cardiology wards | ||||||||
| Confirmed HF admissions | 264 | 309 | 79 | 96 | 106 | 123 | 48 | 56 |
| Mean length of stay (days) | 7.3 | 6.6 | 9.2 | 7.5 | 6.6 | 6.3 | 7.3 | 7.4 |
| Mortality | 22.3% (59) | 20.7% (64) (p=0.634) | 21.5% (17) | 20.8% (20) (p=0.912) | 17.0% (18) | 15.4% (19) (p=0.753) | 20.8% (10) | 19.6% (11) (p=0.880) |
| In-patient | 12.1% (32) | 15.2% (47) (p=0.285) | 16.5% (13) | 10.4% (10) (p=0.239) | 5.7% (6) | 12.2% (15) (p=0.088) | 16.7% (8) | 16.1% (9) (p=0.935) |
| <30 days post-d/c | 11.6% (27) | 6.5% (17) (p=0.045) | 6.1% (4) | 11.6% (10) (p=0.239) | 12.0% (12) | 3.7% (4) (p=0.025) | 5.0% (2) | 4.3% (2) (p=0.869) |
| Readmission <30 days | 23.3% (54) | 22.9% (60) (p=0.921) | 24.2% (16) | 23.3% (20) (p=0.887) | 22.0% (22) | 22.2% (24) (p=0.969) | 25% (10) | 25.5% (12) (p=0.955) |
| Related to HF | 10.8% (25) | 9.5% (25) (p=0.650) | 10.6% (7) | 12.8% (11) (p=0.679) | 10% (10) | 5.6% (6) (p=0.229) | 12.5% (5) | 12.8% (6) (p=0.970) |
| Unrelated to HF | 12.5% (29) | 13.4% (35) (p=0.777) | 13.6% (9) | 10.5% (9) (p=0.549) | 12% (12) | 16.7% (18) (p=0.338) | 12.5% (5) | 12.8% (6) (p=0.970) |
*Mortality as a composite of number that died during admission and number that died within 30 days of discharge (d/c).
†<30-day post-discharge readmission and mortality expressed as percentage of those surviving to discharge.
HF, heart failure; IHFS, integrated heart failure service.