Author/Editor		Keber, Irena; Lainščak, Mitja; Horvat, Alojz; Dobovišek, Jurij
Title		Obravnava bolnikov s srčnim popuščanjem v splošni in univerzitetni bolnišnici v letu 1997
Translated title		Treatment of heart failure patients in university and general hospital in 1997
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 3
Publication year		2003
Volume		str. 135-40
Language		slo
Abstract		Background. Chronic heart failure is a serious condition with high morbidity and mortality. Prognosis can be improved with early diagnosis and adequate nonpharmacologic and pharmacologic treatment. Aims of the study. Aim of the study was a comparison of diagnostic and therapeutic management of patients who were hospitalized in the University or Community hospital Methods. The hospital records of patients, hospitalized for heart failure, from University hospital (UH, Internal clinic, Department of angiology, Department of hypertension) and Community hospital (CH, Department of Internal medicine) were reviewed retrospectively. We included all consecutive patients in the period from January 1, 1997 to June 30, 1997 (CH) and December 31, 1997 (UH) who were discharged or died with diagnosis of a heart failure. Results. Six hundred and twenty five patients (307 from CH and 318 from UH), aged 76 ± 11 years, were included in the survey. In 308 (49%) patients heart failure was diagnosed prior to index hospitalization. Rehospitalization rate was 42%. Etiology of heart failure was ischemic heart disease (36%), arterial hypertension (37%), dilated cardiomyopathy (16%) and valvular heart disease (15%). The hospital stay was 14 ± 10 days in UH and 10 ± 6 days in CH (p < 0.001). Overall in-hospital mortality reached 16% (98 patients) and was 8% in UH and 24% in CH (< 0.001). Echocardiography was performed in UH in 45% and in CH in 13 % of all patients and in 50% vs. 22% of patients, hospitalized for the first time. At the discharge the following drugs were prescribed (UH vs. CH): diuretics (82% vs. 73%), ACE inhibitors (61% vs. 33%), digoxin (54% vs. 71 %) beta-adrenergic blockers (3% vs. 0%) and antiarrhytmics (7% vs. 32%). (Abstract truncated at 2000 characters).
Summary		Izhodišča. Kronično srčno popuščanje povzroča veliko zbolevnost in umrljivost. Prognozo lahko izboljšamo s hitro diagnostiko in pravilnim farmakološkim in nefarmakološkim zdravljenjem. Namen raziskave. Primerjali smo diagnostične in terapevtske postopke pri bolnikih s srčnim popuščanjem, ki so bili hospitalizirani v univerzitetni in regionalni splošni bolnišnici. Metode. V retrospektivni raziskavi smo podatke zbrali s pregledom bolnišnične dokumentacije zaporednih bolnikov, ki so bili hospitalizirani od 1. 1. 2997 do 30. 6 1997 (Splošna bolnišnica Murska Sobota - SB) in do 31. 12. 1997 (Klinični center, Interne klinike, Klinični oddelek za žilne bolezni, Klinični oddelek za hipertenzijo - UB) in so bili odpuščeni ali so umrli z diagnozo srčno popuščanje. Rezultati. Vključili smo 625 bolnikov, starih 76 +- 12 let, 307 bolnikov iz SB in 318 iz UB. Pri 308 (49%) bolnikih je bila diagnoza srčnega popuščanja postavljena je pred sedanjo hospitalizacijo, pri 260 (42%) bolnikih je šlo za ponovno hospitalizacijo. Etiološko je bil vzrok srčnega popuščanja ishemična bolezen srca pri 36%, arterijska hipertenzija pri 37%, dilatativna kardiomiopatija pri 16% in valvulna hiba pri 15%. Med hospitalizacijo je umrlo 98 bolnikov (16%), v SB 24% in v UB 8% (p < 0, 001). Trajanje hospitalizacije je bilo v UB 14 +- 10 in v SB 10 +- 6 dni (p < p, 001). Ultrazvočna preiskava srca je bila opravljena v UB pri 45% in v SB pri 13% vseh bolnikov (p < 0, 001) in pri 50% ter 22% bolnikov, prvikrat hospitaliziranih zaradi srčnega popuščanja. Farmakološko zdravljenje, predpisano ob odpustu, je bilo (UB vs. SB): diuretiki (82% vs. 73%), zaviralci angiotenzinske konvertaze (61 % vs. 33%), digitalis (54% vs. 71 %), zaviralci beta-adrenergičnih receptorjev (3% vs. 0%), antiaritmiki (7% vs. 32%). Med bolniki s sistolično disfunkcijo jih je 69% iz UB in 32% iz SB prejemalo zaviralce ACE. (Izvleček prekinjen pri 2000 znakih).
Descriptors		HEART FAILURE, CONGESTIVE HOSPITALS, GENERAL HOSPITALS, UNIVERSITY RETROSPECTIVE STUDIES