These are the key findings from the National Heart Failure Audit 2010-2011. The information below indicates the findings of the Audit and key findings.
Between April 2010 and March 2011, 133 out of 156 (85%) NHS Trusts and Welsh Health Boards participated in the audit and submitted data on 36,504 patient records. This is a 71% increase in the number of records collected from 2009/2010.
• Nationally the audit represents approximately 54% of all patients discharged from hospital with a primary discharge diagnosis of heart failure – this is an improvement in case ascertainment from 42% of all patients represented in the 2009/10 audit. However, case ascertainment differs significantly between England (58%) and Wales (7%) and also between individual Trusts
• Data completeness for core fields achieved similarly high rates as in 2009/10.
• Treatment rates at discharge for contemporary disease modifying therapies are similar to last year.
• Treatment rates for diuretics (86%) and angiotensin- converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) (81%) remain high.
• Beta blocker prescription rates are similar to those of last year (65%). This is still suboptimal.
• Only 36% of patients were prescribed aldosterone receptor antagonists (ARA).
• Treatment rates for ACE inhibitors/ARBs and beta blockers are significantly better when patients are admitted to cardiology rather than general medical wards.
• Mortality rates remain high, with 33% of patients in the audit dead at the end of the follow up period (median follow up of 306 days).
• In hospital mortality rates were at 11.6%, higher than in contemporary US and European registries.
• The overall death and/or readmission rate to hospital with heart failure during the period of the audit was 51%, almost identical to last year’s data.
• In-patient mortality rates are better for those admitted to cardiology wards (8%) compared to those in general medical wards (14%) and other wards (17%), figures which are only partly accounted for by known confounders such as age and co-morbidity.
• Mortality rates after discharge are significantly better for those who receive cardiology follow up (18% vs. 31%) and those referred to heart failure specialist nursing services (22% vs. 27%) compared to those who do not. Again these differences are not solely due to differences in patient characteristics.
• Mortality rates with key medical treatment (ACE Inhibitors/ ARBs, beta blockers, ARAs) are substantially lower than without such therapy. Access to these drugs is higher for patients admitted to cardiology ward.
You can read the full Audit here – Heart Failure Audit 2010-2011
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