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Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit

(1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need...

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Autores principales: Aguilar-Fuerte, Marta, Alonso-Ecenarro, Fernando, Broch-Petit, Alejandro, Chover-Sierra, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498741/
https://www.ncbi.nlm.nih.gov/pubmed/36141221
http://dx.doi.org/10.3390/healthcare10091609
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author Aguilar-Fuerte, Marta
Alonso-Ecenarro, Fernando
Broch-Petit, Alejandro
Chover-Sierra, Elena
author_facet Aguilar-Fuerte, Marta
Alonso-Ecenarro, Fernando
Broch-Petit, Alejandro
Chover-Sierra, Elena
author_sort Aguilar-Fuerte, Marta
collection PubMed
description (1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need for palliative care. This study aims to identify palliative care needs in HF patients and describe clinical features related to short-term mortality. (2) Methods: A descriptive, observational, cross-sectional, and retrospective study was carried out in an HF unit of a Spanish tertiary hospital. Patients’ socio-demographic and clinical data were collected from clinical records, and different instruments were used to establish mortality risks and patients’ needs for palliative care. Subsequently, univariate and bivariate descriptive analyses were performed. A binary logistic regression model helped to determine variables that could influence mortality 12 months after admission to the Unit. (3) Results: The studied population, sixty-five percent women, had an average age of 83.27 years. Among other clinical characteristics predominated preserved ejection fraction (pEF) and dyspnea NYHA (New York Heart Association) class II. The most prevalent comorbidities were hypertension and coronary heart disease. Forty-nine percent had a low–intermediate mortality risk in the following year, according to the PROFUND index. The NECPAL CCOMS-ICO© instrument identified subjects who meet the criteria for palliative care. This predictive model identified NECPAL CCOMS-ICO© results, using beta-blockers (BB) or AIIRA (Angiotensin II receptor antagonists) and low glomerular filtration rate (GFR) as explanatory variables of patients’ mortality in the following year. (4) Conclusions: The analysis of the characteristics of the population with HF allows us to identify patients in need of palliative care. The NECPAL CCOMS-ICO© instrument and the PROFUND have helped identify the characteristics of people with HF who would benefit from palliative management.
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spelling pubmed-94987412022-09-23 Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit Aguilar-Fuerte, Marta Alonso-Ecenarro, Fernando Broch-Petit, Alejandro Chover-Sierra, Elena Healthcare (Basel) Article (1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need for palliative care. This study aims to identify palliative care needs in HF patients and describe clinical features related to short-term mortality. (2) Methods: A descriptive, observational, cross-sectional, and retrospective study was carried out in an HF unit of a Spanish tertiary hospital. Patients’ socio-demographic and clinical data were collected from clinical records, and different instruments were used to establish mortality risks and patients’ needs for palliative care. Subsequently, univariate and bivariate descriptive analyses were performed. A binary logistic regression model helped to determine variables that could influence mortality 12 months after admission to the Unit. (3) Results: The studied population, sixty-five percent women, had an average age of 83.27 years. Among other clinical characteristics predominated preserved ejection fraction (pEF) and dyspnea NYHA (New York Heart Association) class II. The most prevalent comorbidities were hypertension and coronary heart disease. Forty-nine percent had a low–intermediate mortality risk in the following year, according to the PROFUND index. The NECPAL CCOMS-ICO© instrument identified subjects who meet the criteria for palliative care. This predictive model identified NECPAL CCOMS-ICO© results, using beta-blockers (BB) or AIIRA (Angiotensin II receptor antagonists) and low glomerular filtration rate (GFR) as explanatory variables of patients’ mortality in the following year. (4) Conclusions: The analysis of the characteristics of the population with HF allows us to identify patients in need of palliative care. The NECPAL CCOMS-ICO© instrument and the PROFUND have helped identify the characteristics of people with HF who would benefit from palliative management. MDPI 2022-08-24 /pmc/articles/PMC9498741/ /pubmed/36141221 http://dx.doi.org/10.3390/healthcare10091609 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aguilar-Fuerte, Marta
Alonso-Ecenarro, Fernando
Broch-Petit, Alejandro
Chover-Sierra, Elena
Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title_full Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title_fullStr Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title_full_unstemmed Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title_short Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit
title_sort palliative care needs and clinical features related to short-term mortality in patients enrolled in a heart failure unit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498741/
https://www.ncbi.nlm.nih.gov/pubmed/36141221
http://dx.doi.org/10.3390/healthcare10091609
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