8 October 2014
New guidelines on how hospitals should care for patients with suspected heart failure could prevent over 1,300 i
deaths a year in England and Wales. The updated guidance, published today ii
, by the National Institute for Health and Care Excellence (NICE), outlines best practice on diagnosing and managing heart failure in adults who are admitted to hospital as an emergency.
Latest statistics from the national heart failure audit, published by NICOR (National Institute for Cardiovascular Outcomes Research), show that there are more than 70,000 unplanned hospital admissions every year as a result of heart failure and almost one in ten patients die in hospital.
However, despite the large number of patients affected, almost half are not seen by a consultant cardiologist and over twenty per cent – almost 15,000 patients – currently receive no input from any heart failure specialist whilst in hospital.
The new recommendations say that all hospitals admitting people with suspected acute heart failure should provide a dedicated service that is based on a cardiology ward and provides outreach to other wards in the hospital. The aim is to ensure that all of these patients are, in future, seen early and continuously by a consultant cardiologist, or another member of the hospital’s heart failure team, for example, a heart failure nurse specialist.
Royal Brompton & Harefield NHS Foundation Trust consultant cardiologist, Professor Martin Cowie
, was one of the experts who helped to develop the new NICE guideline and he welcomed its publication today.
“It may come as a surprise to many patients to know they could be admitted to hospital with suspected heart failure but only have around a 50/50 chance of being treated by a cardiologist. Whilst it is not always feasible for every heart failure patient to see a consultant cardiologist, the concern has been that many patients haven’t had access to any heart failure specialist at all. These patients are almost twice as likely to die in hospital compared with those who receive specialist input.
“The new NICE guideline aims to address the variation in the quality of care that currently exists between different hospitals and will ultimately lead to more lives being saved. Patient outcomes will improve as a result of a more rapid diagnosis, improved access to life-saving drug therapies and better follow-up care after discharge from hospital.”
In-hospital mortality is reduced from 9.4% to 7.5% when patients admitted with suspected heart failure have input from a heart failure specialist: http://www.ucl.ac.uk/nicor/audits/heartfailure/documents/annualreports/hfannual12-13.pdf https://www.nice.org.uk/guidance/cg187/resources/guidance-acute-heart-failure-pdf