Chronic Heart Failure in Home Hospitalization

Abstract

INTRODUCTION: Chronic heart failure (CHF) is considered, worldwide, the main cause for hospitalization in patients over the age of 65 years old. The Home Hospitalization Unit (HHU) was created in order to minimize hospital complications, to provide a better quality of life and to achieve better functional results.
MATERIAL AND METHODS: Retrospective study of one year of home hospitalization (HH) at the Local Health Unit in Castelo Branco, focusing only in hospitalized patients due to chronic heart failure decompensation.
RESULTS: During this period, 99 patients were hospitalized, 23.3% due to decompensated heart failure). Were male, 52.1%. The average age was 79.8 years old (±10.6). The average hospital stay was 6.7 days (±3). The main causes of heart failure were hypertension (43.4%) and arrhythmias (30.4%). The main factor for decompensation was infections (69.5%). Were under initial infusion of furosemide, 56.5% of the patients. Evolved favorably 95.6% (n=22) of the patients and one (4.3%) was transferred to conventional hospitalization. According to the NEWS scale, 7.9%-12.7% of the patients were at risk of
being admitted to an intermediate/intensive care unit or at risk of dying within 60 days. Charlson’s comorbidity index was 3-10 points and survival in a subsequent 10-year period was estimated at 0%-77%. Ninety days after discharge, 69.5% of the patients did not return to the emergency department neither were they readmitted.
CONCLUSION: Home hospitalization in patients with HF is advantageous because it provides greater comfort to the patient and reduces complications. Studies have shown that HH increased the time between readmissions, improved patients’ quality
of life and reduced hospitalization costs.