TITLE:
Heart Failure: Organization of Care after Hospitalization at the Abidjan Cardiology Institute
AUTHORS:
Djenamba Bamba-Kamagaté, Esaïe Soya, Mbe Dagnogo, Kouassi Florent Koffi, Parfait Kouame, Jean Baptiste Anzouan-Kacou
KEYWORDS:
Care Pathway, Hospitalization Suites, Heart Failure, Outpatient
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.9,
September
28,
2023
ABSTRACT: Introduction: The care pathway for heart failure (HF) patients is
poorly documented in sub-Saharan Africa. A multidisciplinary management reduces
hospitalizations and mortality. In our context of frequent rehospitalization of heart failure patients, the objective of this
study was to analyse the post-hospital follow-up health care. Methods: We
conducted a prospective study in the medical department of a Heart Institute
from January 1st to December 31, 2015. Patients over 18 years of
age, hospitalized for heart failure, consenting and followed up on an
outpatient basis for 2 years were included. Results: We collected 396
patients hospitalized for HF. The mean age was 57.4 ± 16 years with a male
predominance (59.3%). Retired and unemployed people represented 27% and 16.2% respectively.
During the post-hospitalization follow-up, patients who were regularly
followed up represented 10.8% of the cases. 74.1% of the cases were regular
patients. Patients were not followed up by the usual practitioner (58.2%). Only
94 patients had undergone a cardiovascular rehabilitation programme, of which
21.3% for exercise rehabilitation and 78.7% for therapeutic education. Patients
who had attended titration sessions (n = 59) had reached optimal doses of ACE inhibitors, ARB
II and beta blockers in 67.8%, 7.3% and 38.5% respectively. The rates of
decompensation (73.3%) and rehospitalization (49.5%) were higher. The
paraclinic check-up (ECG, X-ray, Cardiac Doppler ultrasonography, Biology) was
rarely requested. The probability of survival was higher in patients regularly
monitored than in those irregularly monitored. Conclusion: The
organisation of care and coordination between professionals should be
structured or planned. Therapeutic strategies need to be intensified in
order to optimise their long-term benefits.