Nurse-Led Heart Failure Clinics Are Associated With Reduced Mortality but Not Heart Failure Hospitalization.

Content Provider	Europe PMC
Author	Savarese, Gianluigi Lund, Lars H. Dahlström, Ulf Strömberg, Anna
Abstract	BackgroundFollow‐up in a nurse‐led heart failure (HF) clinic is recommended in HF guidelines, but its association with outcomes remains controversial, with previous studies including few and highly selected patients. Thus, large analyses of “real‐world” samples are needed. Aims were to assess: (1) independent predictors of and (2) prognosis associated with planned referral to nurse‐led HF clinics.Methods and ResultsWe analyzed data from the SwedeHF (Swedish HF Registry) using multivariable logistic regressions to identify independent predictors of planned referral to a nurse‐led HF clinic and multivariable Cox regressions to test associations between planned referral and outcomes (all‐cause death, HF hospitalization, and their composite). Of 40 992 patients, 39% were planned to be referred to a follow‐up in a nurse‐led HF clinic. Independent characteristics associated with planned referral were shorter duration of HF, clinical markers of more‐severe HF, such as lower ejection fraction, higher New York Heart Association class and N‐terminal pro‐B‐type natriuretic peptide, and lower blood pressure, as well as cohabitating versus living alone, male sex, fewer comorbidities, and more use of HF treatments. After adjustments, planned referral to a nurse‐led HF clinic was associated with reduced mortality and mortality/HF hospitalization, but not HF hospitalization alone.ConclusionsIn this nation‐wide registry, 39% of our identified HF cohort was planned to be referred to a nurse‐led HF clinic. Planned referral reflected more‐severe HF, but also sex‐ and family‐related factors, and it was independently associated with lower risk of death, but not of HF hospitalization.
Page Count	15
Journal	Journal of the American Heart Association
Volume Number	8
PubMed Central reference number	PMC6585319
Issue Number	10
PubMed reference number	31094284
e-ISSN	20479980
DOI	10.1161/jaha.118.011737
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2019-05-01
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Subject Keyword	follow‐up heart failure hospitalization nurse‐led clinic registry survival Nursing Health Services Mortality/Survival Quality and Outcomes Statements and Guidelines
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine