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Georges JL, Gaulupeau V, Chanut A, Merceron A, Delaroche-Vernet S, Harboun M, Chayeb S, Sadeg O, Aribi EH, Galindo G, Sekour K, Bornand A, Romain D. [Management of congestive heart failure in the elderly after hospitalization for acute decompensation Interest of a dedicated territorial geriatric network ; the GERICCO-78 study]. Ann Cardiol Angeiol (Paris) 2022; 71:259-266. [PMID: 36041961 DOI: 10.1016/j.ancard.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
AIMS Heart failure (HF) is the leading cause of hospitalisation in the elderly in France. Early rehospitalisations are common, often through an emergency department. The aim of this study was to assess the impact of a primary care-hospital coordination network, with interventions by coordination nurses (IDEC), on the rehospitalisations after a first hospitalisation for acute decompensation in frail elderly HF patients. METHODS From 01/10/2019 to 01/10/2021, 237 patients aged > 75 years with frailty criteria, hospitalised in 8 departments of 5 private or public hospitals in the Yvelines Sud health territory were followed by an IDEC (hospital visit, telephone contacts, home visit(s)) within 3 months of their return home. This prospective observational study analysed the rate of consultations to the emergency room, rehospitalisations (total and for acute HF), and the number of events avoided at 90 days after discharge. RESULTS The mean age of the patients was 87 years, 54% were women, 68% had a left ventricular ejection fraction > 40%, and 70% had atrial fibrillation. Non-cardiac comorbidities were very frequent. At 3-month follow-up, mortality was 9.3% (22/237), only 27 patients (11.3%) consulted the emergency room for acute HF, and the rehospitalisation rate for HF was 19.8%, without difference according to left ventricular ejection fraction. A consultation to the emergency room or a rehospitalisation for heart failure could be avoided for 10% of patients. CONCLUSION This study suggests that a primary care-hospital coordination network with dedicated coordination nurses is useful for the management of very elderly frail patients following hospitalisation for heart failure, limiting visits to the emergency room and rehospitalisations.
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Affiliation(s)
- Jean-Louis Georges
- Service de Cardiologie, Centre Hospitalier de Versailles, Hôpital André Mignot, 177 rue de Versailles, 78157, Le Chesnay-Rocquencourt, France.
| | - Violaine Gaulupeau
- Service de Cardiologie, Centre Hospitalier de Versailles, Hôpital André Mignot, 177 rue de Versailles, 78157, Le Chesnay-Rocquencourt, France
| | - Anais Chanut
- Infirmière Coordinatrice, Cellule de coordination ville-hôpital, et réseau REPY, Centre Hospitalier de Versailles, Le Chesnay-Rocquencourt, France
| | - Annick Merceron
- Infirmière Coordinatrice, Cellule de coordination ville-hôpital, et réseau REPY, Centre Hospitalier de Plaisir, Plaisir, France
| | - Sophie Delaroche-Vernet
- Infirmière Coordinatrice, Cellule de coordination ville-hôpital, et réseau REPY, Centre Hospitalier de Versailles, Le Chesnay-Rocquencourt, France
| | - Marc Harboun
- Service de gériatrie aiguë et soins de suite gériatrique, Hôpital Privé de la Porte Verte, Versailles, France
| | - Samir Chayeb
- Service de Cardiologie, Centre Hospitalier de Rambouillet, Rambouillet, France
| | - Ouali Sadeg
- Service de gériatrie aiguë , Centre Hospitalier de Plaisir, Plaisir, France
| | - El Heddi Aribi
- Service de soins de suite gériatriques, Centre Hospitalier de Plaisir, Plaisir, France
| | - Géraldine Galindo
- Service de gériatrie aiguë, Centre Hospitalier de Rambouillet, Rambouillet, France
| | - Kaci Sekour
- Service de médecine et soins de suite gériatriques, Centre Hospitalier de la Mauldre, Jouars Pontchartrain, France
| | - Anne Bornand
- Service de gériatrie aiguë, Pôle de gériatrie, Centre Hospitalier de Versailles, Hôpital André Mignot, Le Chesnay-Rocquencourt, France
| | - Delphine Romain
- Service de soins de suite gériatriques, Pôle de gériatrie, Centre Hospitalier de Versailles, Hôpital Richaud, Versailles, France
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